Skin changes in patients with chronic renal failure

Management of patients with renal failure remains a major problem in poor-resource nations. Cutaneous manifestations in this group of patients are varied and remain helpful in differentiating acute from chronic renal failure (CRF). We studied the prevalence and pattern of skin disorders in patients with CRF at The University College Hospital, Ibadan, Nigeria, during the period between May 2006 and February 2007. Relevant information was collected with the aid of a questionnaire. The patients were then examined for skin disorders. One hundred and twenty patients who met the inclusion criteria were recruited into the study. The mean age of the CRF patients was 43.12 ± 15.38 years, while that of the control subjects was 43.13 ± 15.38 years. Seventy-six of the 120 patients (63.3%) were on chronic hemodialysis while 44 (36.5%) were on conservative management. A total of 107 patients (89.1%) had at least one skin problem. The skin disorders seen include xerosis in 72 (60%), pruritus in 32 (26.7%), hyperpigmentation, icthyosis and pityriasis versicolor in nine patients each (7.5%), either singly or in combination. Pallor of the skin was seen in three of the patients (2.5%), while uremic frost was seen in one (0.8%). Nail changes were seen in 48 patients (40%). We conclude that xerosis, pruritus, pigmentary and nail changes were the most common skin disorders in patients with CRF in our environment.