[Normalization of uremic skin changes following kidney transplantation]

A clinical dermatological examination was performed on 49 patients (30 males, 19 females; 24-64 years of age) 3.1 years after successful kidney transplantation. Some patients underwent skin biopsy procedures for examination by light and electron microscopy, as well as immunohistological methods. Six patients had already been examined using these methods prior to the transplantation. When sufficient renal function was restored after successful kidney transplantation, the uremic skin alterations disappeared. The increase in sweat secretion, a common symptom in uremic patients was not observed after renal transplantation. The ichthyosiform feature of uremic skin and the increased vulnerability of the skin was observed in only a minority of the transplanted patients examined. In addition, the generalized pruritus and Raynaud phenomenon that are seen so frequently among uremic patients disappeared completely. However, the uremic-induced alterations of the connective tissue, like severe actinic elastosis and Dupuytren's contractures, persisted after renal transplantation. Histological examinations revealed renormalization of the uremic altered skin; in particular, the severe microangiopathy of skin vessels in long-term hemodialysis patients vanished.