Stratum corneum hydration in patients undergoing maintenance hemodialysis

Dry-looking skin of unknown etiology develops in a majority of patients with chronic renal failure. The hydration of the stratum corneum influences the appearance of the skin and lack of water is considered to induce roughness, e.g. in atopic dermatitis. The aim of the present study was to compare the water content in uremic and healthy skin and to evaluate the possible relationship between skin hydration and pruritus in uremic patients. Thirty-one patients, 19 with pruritus, undergoing chronic hemodialysis participated. Twelve healthy age-matched subjects served as controls. The skin of the uremic patients appeared generally xerotic, whereas the controls had normal-looking skin. The water content of the stratum corneum was recorded with the Corneometer, a capacitance-measuring device, on three different sites: the neck, the chest and the lower leg. There was a significant difference in water content between locations in all groups, the water content being highest in the neck and lowest in the leg (p less than 0.01). There was a tendency that patients with pruritus had a lower water content than patients without pruritus, but there was no significant difference between uremic patients and controls. Hence, insufficient hydration does not seem to explain the difference in skin texture between uremic patients and healthy subjects.