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Factors Affecting Dermatological Manifestations in Patients with End Stage Renal Disease.
J Coll Physicians Surg Pak 2018; 28(2):98-102JC

Abstract

OBJECTIVE

To determine skin changes in patients of End Stage Renal Disease (ESRD) on maintenance hemodialysis (MHD) and factors affecting these changes.

STUDY DESIGN

Cross-sectional observational study.

PLACE AND DURATION OF STUDY

Nephrology Department, Mayo Hospital, Lahore in collaboration with Dermatology Department, King Edward Medical University, Lahore, from October 2015 to January 2016.

METHODOLOGY

Two hundred patients who were undergoing MHD for more than three months were included in the study. Patients' demographic data, laboratory reports and dialysis records were noted in a predesigned questionnaire. Skin examination was carried out by consultant dermatologist after patient's permission.

RESULTS

Among 200 patients included in study, 105 were malesand rest of them were females. Major causes of ESRD were Diabetes Mellitus (n=83, 41.5%, followed by Hypertension (n=80, 40%), Nephrolithiasis (n=15, 7.5%) and Chronic glomerulonephritis (n=5, 2.5%). At least one cutaneous finding was present in every patient. Common skin findings observed were pigmentation (86%), xerosis (83%), pallor (79%), pruritus (69%), acquired ichthyosis (50.5%), and bacterial skin infections (18.5%). Among them, nail manifestations were half-and-half nails (52%), onychomycosis (30.5%), onycholysis (20.5%), subungual hyperkeratosis (23.5%), and Mee's lines (7.5). Among hair changes were sparse scalp hair (38.5%), brittle and lustreless hair (28%). The factors contributing to skin changes were patient's age, cause of ESRD, anti HCV positivity, high urea and creatinine levels, duration and frequency of hemodialysis, hemoglobin levels, calcium phosphate product and socioeconomic status. Some skin manifestations were interrelated with each other like xerosis with pruritus (p<0.001), pruritus with bacterial infection (p<0.022), acquired Ichthyosis (p=0.008) and hair changes (p=0.035).

CONCLUSION

ESRD patients on hemodialysis develop various skin changes during the course of disease process, which contribute to increased morbidity. Different factors affecting skin changes were the cause of ESRD, adequacy and duration of dialysis, employment, financial status, anti HCV positivity, and metabolic factors.

Authors+Show Affiliations

Department of Nephrology, King Edward Medical University (KEMU), Lahore.Department of Dermatology, King Edward Medical University (KEMU), Lahore.Department of Nephrology, King Edward Medical University (KEMU), Lahore.Department of Nephrology, King Edward Medical University (KEMU), Lahore.Department of Dermatology, King Edward Medical University (KEMU), Lahore.Statistician, Government MAO College, Lahore.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29394966

Citation

Anees, Muhammad, et al. "Factors Affecting Dermatological Manifestations in Patients With End Stage Renal Disease." Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, vol. 28, no. 2, 2018, pp. 98-102.
Anees M, Butt G, Gull S, et al. Factors Affecting Dermatological Manifestations in Patients with End Stage Renal Disease. J Coll Physicians Surg Pak. 2018;28(2):98-102.
Anees, M., Butt, G., Gull, S., Nazeer, A., Hussain, I., & Ibrahim, M. (2018). Factors Affecting Dermatological Manifestations in Patients with End Stage Renal Disease. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 28(2), pp. 98-102. doi:10.29271/jcpsp.2018.02.98.
Anees M, et al. Factors Affecting Dermatological Manifestations in Patients With End Stage Renal Disease. J Coll Physicians Surg Pak. 2018;28(2):98-102. PubMed PMID: 29394966.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors Affecting Dermatological Manifestations in Patients with End Stage Renal Disease. AU - Anees,Muhammad, AU - Butt,Ghazala, AU - Gull,Shaista, AU - Nazeer,Asif, AU - Hussain,Ijaz, AU - Ibrahim,Muhammad, PY - 2016/07/18/received PY - 2017/12/18/accepted PY - 2018/2/4/entrez PY - 2018/2/6/pubmed PY - 2018/6/23/medline SP - 98 EP - 102 JF - Journal of the College of Physicians and Surgeons--Pakistan : JCPSP JO - J Coll Physicians Surg Pak VL - 28 IS - 2 N2 - OBJECTIVE: To determine skin changes in patients of End Stage Renal Disease (ESRD) on maintenance hemodialysis (MHD) and factors affecting these changes. STUDY DESIGN: Cross-sectional observational study. PLACE AND DURATION OF STUDY: Nephrology Department, Mayo Hospital, Lahore in collaboration with Dermatology Department, King Edward Medical University, Lahore, from October 2015 to January 2016. METHODOLOGY: Two hundred patients who were undergoing MHD for more than three months were included in the study. Patients' demographic data, laboratory reports and dialysis records were noted in a predesigned questionnaire. Skin examination was carried out by consultant dermatologist after patient's permission. RESULTS: Among 200 patients included in study, 105 were malesand rest of them were females. Major causes of ESRD were Diabetes Mellitus (n=83, 41.5%, followed by Hypertension (n=80, 40%), Nephrolithiasis (n=15, 7.5%) and Chronic glomerulonephritis (n=5, 2.5%). At least one cutaneous finding was present in every patient. Common skin findings observed were pigmentation (86%), xerosis (83%), pallor (79%), pruritus (69%), acquired ichthyosis (50.5%), and bacterial skin infections (18.5%). Among them, nail manifestations were half-and-half nails (52%), onychomycosis (30.5%), onycholysis (20.5%), subungual hyperkeratosis (23.5%), and Mee's lines (7.5). Among hair changes were sparse scalp hair (38.5%), brittle and lustreless hair (28%). The factors contributing to skin changes were patient's age, cause of ESRD, anti HCV positivity, high urea and creatinine levels, duration and frequency of hemodialysis, hemoglobin levels, calcium phosphate product and socioeconomic status. Some skin manifestations were interrelated with each other like xerosis with pruritus (p<0.001), pruritus with bacterial infection (p<0.022), acquired Ichthyosis (p=0.008) and hair changes (p=0.035). CONCLUSION: ESRD patients on hemodialysis develop various skin changes during the course of disease process, which contribute to increased morbidity. Different factors affecting skin changes were the cause of ESRD, adequacy and duration of dialysis, employment, financial status, anti HCV positivity, and metabolic factors. SN - 1681-7168 UR - https://www.unboundmedicine.com/medline/citation/29394966/Factors_Affecting_Dermatological_Manifestations_in_Patients_with_End_Stage_Renal_Disease_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -