Dermatological manifestations among patients on maintenance hemodialysis

Introduction. Patients with chronic kidney disease on hemodialysis (HD) undergo many dermatological signs and symptoms during treatment. The aim of this study was to investigate the prevalence of skin manifestations among the patients on maintenance HD in the HD center of Boo Ali-Sina Hospital (Qazvin, Iran) and compare them with the general population.

From June 2012 to July 2012 a case-controlled study was performed with 149 patients with end-stage renal disease undergoing regular HD (HD group) and 150 individuals who were randomly selected (control group) from healthy hospital staff at Boo Ali-Sina Hospital. A dermatologist examined all individuals in both groups to assess of skin, hair, nail, and mucosal tissues.

Overall, 108 of the patients in the HD group and 54 of the individuals in the control group were found to have at least 1 cutaneous and mocusal manifestation. Pruritus, skin discoloration, ecchymosis, drying and hair fragility, leukonychia, absent lunula, and half and half nails were more frequent in the HD group than compared to the control group (P < 0.05). Although no significant correlation between dermatological manifestations and age ≥ 65 or diabetes mellitus were made, multiple logistic regression analysis indicated that male sex, hypertension, and long-term HD were associated with dermatological manifestations.

In the present study, cutaneous and mocusal manifestations ranged from 36% in the control group to 72.4% in the HD group. The results also indicate a relationship between cutaneous and mocusal manifestations, and male sex, hypertension, and duration of dialysis in HD patients. .