Abstract
Introduction: Dermatological conditions are common complications of Chronic Kidney Disease (CKD) affecting all most all patients. Present study aimed to evaluate the dermatological conditions and their association with age, sex and severity of CKD - without and with maintenance hemodialysis (MHD).Methods: It is a cross sectional and comparative study. Eighty-three patients with established CKD, without MHD (n=35) and with MHD (n= 48), attending nephrology unit, Bir Hospital and Shree Birendra Hospital from June 2008 to May 2009 were examined for dermatological disorders.Results: The mean age of patients were 46+15.6 years with male to female ratio of 1.8:1. Comparison of CKD without MHD and with MHD showed no statistical difference of age, sex, duration of treatment, blood urea and haemoglobin and significant difference of serum creatinine (5.3 + 3.0 mg/dl vs 9.1 + 4.5 mg/dl, p<0.001) respectively.Dermatological conditions were found in 100% CKD patients with pallor 91.5%, xerosis 75.9%, pigmentary changes 65%, pruritus 60.2%, skin infection 36.9%, vascular changes 16.8%, mucosal changes 67.4%, hair changes 59%, non -specific nail changes 81.9% and specific nail changes14.4%,.Specific (23.2% vs. 8.4%, p<0.03) and non- specific (91.4% vs 75%, p < 0.05) nail changes and hair abnormalities (74.3% vs. 47.9%, p<0.01) were significantly higher in CKD without MHD.Conclusions: Dermatological conditions are present in all CKD patients with or without MHD. A further prospective study is necessary to find out pathophysiology and beneficial effect of dialysis and transplantation in these conditions.Key words: chronic kidney disease, dermatological disorder, maintenance hemodialysis.
Highlights
Dermatological disorders are common complications of Chronic Kidney Disease (CKD) affecting all most all patients
The kidney function of CKD without Maintenance hemodialysis (MHD) was determined by estimating the glomerular filtration rate (GFR) by MDRD (Modification of Diet in Renal Disease) equation and CKD staging done according to KDOQI (Kidney Disease Outcome Quality Initiative) clinical practice guideline.[11,12]
Among CKD without MHD, 6 (17%) patients were in stage 4 and 29 (83%) patients were in stage 5 with estimated GFR (24.4±3.9 and 5.6±2.9) ml/1.73 m2/ min respectively by MDRD equation
Summary
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. Dermatological disorders are common and diverse in patients with Chronic Kidney Disease (CKD) and xerosis, pruritus, pallor and hyperpigmentation are commonly encountered skin changes.[1,2,3] They can significantly affect patient’s quality of life with negative impact in their mental and physical health and early detection and treatment of severe disorders can dramatically alter their course with improvement of quality of life.[4,5,6]. Present study aimed to find out the dermatological disorders in Nepalese CKD with and without MHD and their association with age, sex, severity and duration of CKD and dialysis
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