Multivariate analysis of cutaneous markers of aging in chronic hemodialyzed patients

Although hemodialysis has been associated with lesions of cutaneous aging, no controlled studies have been done in patients with chronic renal failure under periodic hemodialysis. Our purpose was to determine the prevalence of several clinical parameters of cutaneous aging and their relationship with hemodialysis.

One hundred fourteen patients on chronic hemodialysis were investigated for the presence of several cutaneous aging markers in a cross-sectional study, using multivariate analysis to minimize the confounding effect of age.

Skin cancer was diagnosed in 3 patients (2.6%), actinic keratoses in 12 (10.5%), senile lentigo in 22 (20%), senile purpura in 15 (13%), and Favre-Racouchot disease in 6 (5%). There was no association with skin types or facial wrinkles with any other of the skin-aging features studied. Multivariate analysis, controlling for age as a confounding variable, indicated that the degree of facial wrinkles and the decrease in stratum corneum hydration (capacitance) correlated significantly with the length of time on hemodialysis (P = 0.012 and P = 0.012, respectively). Favre-Racouchot disease (Odds Ratio [OR] = 1.23, P = 0.055, 95% confidence interval [CI] 0.99-1.52) and actinic keratoses (OR = 1.15, P = 0.076, CI 0.98-1.34) became increasingly frequent with the duration of chronic hemodialysis.

These data show a high prevalence of cutaneous aging lesions in patients on chronic hemodialysis. Acceleration of cutaneous aging is associated with time on hemodialysis.