Factors Affecting Dermatological Manifestations in Patients with End Stage Renal Disease

Journal of the College of Physicians and Surgeons Pakistan

article

Muhammad Anees¹  Ghazala Butt¹  Shaista Gull¹  Asif Nazeer¹  Ijaz Hussain¹  Muhammad Ibrahim² 

[1] King Edward Medical University;Statistician, Government MAO College

关键词: Chronic kidney disease;    Hemodialysis;    Skin manifestations;    Pruritus;    Xerosis;    Pallor;   

学科分类：医学（综合）

来源: College of Physicians and Surgeons Pakistan. Journal

【 摘 要 】

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 DermatologyDepartment, 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. Skinexamination was carried out by consultant dermatologist after patient's permission.Results: Among 200 patients included in study, 105 were males and rest of them were females. Major causes of ESRDwere Diabetes Mellitus (n=83, 41.5%, followed by Hypertension (n=80, 40%), Nephrolithiasis (n=15, 7.5%) and Chronicglomerulonephritis (n=5, 2.5%). At least one cutaneous finding was present in every patient. Common skin findingsobserved were pigmentation (86%), xerosis (83%), pallor (79%), pruritus (69%), acquired ichthyosis (50.5%), and bacterialskin 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 scalphair (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, calciumphosphate product and socioeconomic status. Some skin manifestations were interrelated with each other like xerosis withpruritus (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, whichcontribute to increased morbidity. Different factors affecting skin changes were the cause of ESRD, adequacy and durationof dialysis, employment, financial status, anti HCV positivity, and metabolic factors.

【 授权许可】

CC BY