Dermatological disorders in chronic kidney disease with and without maintenance hemodialysis.JNMA J Nepal Med Assoc 2013 Apr-Jun; 52(190):365-71JJ
Dermatological disorders are common complications of CKD affecting all most all patients. Present study aimed to evaluate these disorders in CKD with and without Maintenance Hemodialysis and their association with age, sex, severity and duration of CKD and dialysis.
It is a cross-sectional comparative study. Eighty-three patients with established CKD, without MHD (n=35) and with MHD (n= 48), were examined for dermatological disorders.
The mean age of patients were 46±15.6 years with male to female ratio of 1.18:1. Among CKD without MHD, six patients were in stage 4 and 29 patients were in stage 5 with estimated GFR (24.4±3.9 and 5.6±2.9) ml/1.73m2/min respectively by MDRD equation. CKD without and with MHD had similar age, sex, blood urea, hemoglobin. Dermatological disorders were found in 100% CKD patients with pallor 76 (91.5%), xerosis 63 (75.9%), pigmentary changes 54 (65%), pruritus 50 (60.2%), skin infection 40 (48.2%), vascular changes 14 (16.8%), mucosal changes 56 (67.5%), hair changes 49 (59%), non -specific nail changes 68 (81.9%) and specific nail changes 12 (14.4%). Specific 8 (22.8%) vs 4 (8.3%), p<0.03 and non- specific 32 (91.4%) vs 36 (75%), p<0.05 nail changes and hair abnormalities 26 (74.3%) vs. 23 (47.9%), p<0.01 were significantly lower in MHD patients.
Dermatological disorders were present in all CKD patients with significantly lower nail and hair changes in MHD. A further longitudinal study is necessary to find out pathophysiology and effect of treatment in these disorders.