[Microangiopathy, connective tissue changes and amyloid deposits in chronic renal failure]

Skin biopsies were taken from 59 patients with chronic renal failure (52 patients were on regular dialysis treatment, and seven patients were predialytic). The histological examination of the skin biopsies revealed microangiopathy and pericollageneous deposition of a substance with the histochemical behavior of amyloid. In electron microscopy studies these deposits were found to be fine granular, but microfibrillar structures could also be detected. The alterations of the vessel walls are obviously caused by a non-reactive deposition of immunoglobulins, complement components, and fibrinogen. The alteration of the connective tissue mainly imposes as actinic elastosis. These findings could be demonstrated in both predialytic patients and patients on regular dialysis. The extent of the observed alterations seemed to be dependent on the duration of uremia. Atrophy of sweat and sebaceous glands also characterizes the skin lesions of patients with chronic renal failure.