#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Cutaneous Manifestations in Dialysed Patients with Chronic Renal Failure


Authors: M. Kumpová 1;  P. Cetkovská 1;  S. Opatrná 2
Authors‘ workplace: Dermatovenerologická klinika FN a LF UK Plzeň 1;  I. interní klinika FN Plzeň přednosta prof. MUDr. Karel Pizinger, CSc. 2
Published in: Čes-slov Derm, 83, 2008, No. 5, p. 259-264
Category: Clinical and laboratory Research

Overview

Objective:
Assessment of skin changes and characteristics of pruritus in patients with chronic renal failure.

Methods:
The project consisted of clinical check-up and questionnaire focused on pruritus and skin changes.

Results:
In total, 58% of patients experienced pruritus that appeared prior to initiation of dialysis in 27% of them. In 15 % of patients the pruritus was generalized. The same percent reported on pruritus-associated sleep disorders. Analysis of pruritus according to method of dialysis and presence of diabetes mellitus did not reveal significant differences. Pruritus intensity was not dependent on the length of dialysis. In patients with antipruriginous therapy with antihistamines and emollients the treatment was successful in 70% of diabetic patients and in 74% of non-diabetics. Other cutaneous manifestations included skin dryness (87%), elastosis (67%), fungal, bacterial or viral infections (58%), pallor (51%), bruising/ecchymoses (41%), pigmentation (28%), worsened wound healing (28%), ichtyosiform scaling (26%), macroglossia (22%), skin lesions clinically suspicious of malignancy (8%), half-and-half nails (5%), bullous dermatoses (5%), prurigo nodularis (2%), calcifications (1%), gynecomastia (1%), and perforating disorders (1%).

Conclusion:
Chronic renal failure is associated with numerous skin changes with great impact on patient quality of life. Regular dermatological examination to reveal present skin abnormalities and following medical intervention are therefore desirable.

Key words:
chronic renal failure – dialysis – pruritus


Sources

1. ADA, S., SEςKIN, D., BUDAKOGLU, I., et al. Treatment of uremic pruritus with narrowband ultraviolet B phototherapy: an open pilot study. J Am Acad Dermatol, 2005, 53, p. 149-151.

2. CALLEN, JP. Cutaneous nephrology. In: CALLEN, JP., JORIZZO, JL. (Eds) Dermatological signs of internal disease. Elsevier Science Ltd., 3rd Ed, 2003, p. 271-274.

3. CETKOVSKÁ P. Kožní projevy a chronická renální insuficience. Čes-slov Derm, 2008, 83, 2, p. 56-61.

4. CETKOVSKÁ, P., KOŠŤÁLOVÁ, D., EISELT, J. Léčba uremického pruritu UVB fototerapií. Čes-slov Derm, 1992, 67, p. 154-157.

5. DYACHENKO, P. MONSELISE, A., SCHESTAK, A et al. Nail disorders in patients with chronic renal failure and undergoing haemodialysis treatment: a case-control study. JEADV, 2007, 21, p. 340-344.

6. JIRÁSKOVÁ, M., ŠTORK, J. Terapie pruritu u hemodialyzovaných pacientů UV zářením. Čs. Derm, 75, 2000, s. 159-164.

7. NARITA, I., ALCHI, B., OMORI, K. et al. Etiology and prognostic significance of severe uremic pruritus in chronic hemodialysis patients. Kidney Int, 2006, 69 (9), p. 1626-1632.

8. PEHARDA, V., GRUBER, F., KAŠTELAN, M., et al. Pruritus, an important symptom of internal diseases. Acta Dermatol Alpina, Pannonica et Adriatica, 2000, 9 (3), p. 92-104.

9. ROBERTSON, K., Müller, B. Uremic pruritus. Am J Health Syst Pharm, 1996, 53, p. 2159-2170.

10. SZEPIETOWSKI, J.C. et al.: Uremic pruritus: a clinical study of maintenance hemodialysis patients. J Dermatol, 2002, 29, p. 621-627.

11. SZEPIETOWSKI, J.C., MORITA, A., TSUJI, T. Ultraviolet B induces mast cell apoptosis: a hypothetical mechanism of ultraviolet B treatment for uremic pruritus. Med Hypothese, 2002, 58, p.167-170.

12. SZEPIETOWSKI, J.C., SALOMON, J. Uremic pruritus: still an important clinical problem. J Am Acad Dermatol, 2004, 51, p. 842-3.

13. ŠTORK J. Kožní symptomatologie u pacientů v chronickém hemodialyzačním léčení Čs. Derm., 1988, 63, s. 256-265.

14. UDAYAKUMAR, P., BALASUBRAMANIAN, S., RAMALINGAM, K. et al. Cutaneous manifestations in patients with chronic renal failure on hemodialysis. Indian J Dermatol Venereol Leprol, 2006, 72, p. 119-125.

15. ZUCKER, I., YOSIPOVITCH, G., MICHAEL, D., et al. Prevalence and characterization of uremic pruritus in patients undergoing hemodialysis. Uremic pruritus is still a major problem for patients with end-stage renal disease. J Am Acad Dermatol, 2003, 49 (5), p. 842-846.

Labels
Dermatology & STDs Paediatric dermatology & STDs
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#