The Spectrum of Nail Disorders Seen in Patients with End-stage Renal Disease Undergoing Conservative Treatment: A Case–control Study

Abstract

Objective: Various nail disorders have been reported in patients with chronic kidney disease (CKD). However, few studies have investigated nail disorders in patients with advanced CKD. This study focused on nail disorders seen in patients with end-stage renal disease (ESRD) undergoing conservative treatment. Methods: A case–control study was conducted at Baraha Medical City in Khartoum State, Sudan. Patients with ESRD who were on conservative treatment and presented for follow-up between March and September 2021 were enrolled. Patients’ demographic features, nail findings on clinical examination, and laboratory results were recorded. The obtained data were compared with those of age- and sex-matched healthy individuals from the general population. The statistical analysis was performed using SPSS software. Results: Seventy-eight patients with ESRD were studied. Their mean age was 54.6 ± 17.6 years, and 45 (57.7%) were men. These patients were compared with 129 controls. Nail disorders were seen in 83.3% and 66.6% of patients and controls, respectively (P = 0.009). Patients with ESRD were found to be at increased relative risk of developing a wide spectrum of nail disorders. An absent lunula, half-and-half nails, nail dystrophy, Terry’s nails, onychomycosis, and koilonychia were the most common disorders and were seen in 56.4%, 16.7%, 12.8%, 11.5%, 7.7%, and 6.4% of patients, respectively. These disorders had a statistically significant correlation with ESRD (all P < 0.05). Conclusion: The current study demonstrated a wide spectrum of nail disorders in patients with ESRD undergoing conservative treatment. Further studies are essential to understand their pathogenesis.