Evaluation of dermatological manifestations in patients with chronic kidney disease in a hemodialysis service in the Federal District
DOI:
https://doi.org/10.33448/rsd-v13i3.45208Keywords:
Chronic kidney disease; Skin diseases; Renal dialysis.Abstract
Chronic kidney disease (CKD) is defined as the progressive and irreversible loss in the number and function of nephrons for more than 3 months. It is a well-established fact that 82% of CKD patients undergoing hemodialysis experience at least one cutaneous or mucosal alteration, which can negatively impact their quality of life. The aim of this study was to determine the clinical and epidemiological profile of the population with CKD in a hemodialysis service in the Federal District, as well as to evaluate the prevalence of the main dermatological manifestations in these patients. This is a descriptive, retrospective, case series study based on an analysis of medical records, interviews and physical examinations conducted between August 2019 and January 2020. A total of 46 patients were included, with 52% of them being female and the majority aged between 40 and 50. All of the analyzed patients presented dermatological manifestations, with a particular focus on nail alterations (89.6%), xerosis (83.3%), and mucous membrane alterations (77.1%). Studying the clinical and epidemiological profile, as well as cutaneous and mucosal alterations, in these patients is crucial for early diagnosis and intervention.
References
Adejumo, O. A., Madubuko, R. C., Olokor, A. B., & Aina, O. T. (2019). Skin changes and dermatological life quality index in chronic kidney disease patients in a tertiary hospital in Southern Nigeria. Nigerian Journal of Clinical Practice, 22(2), 245–250. https://doi.org/10.4103/njcp.njcp_270_18
Anees, M., Butt, G., Gull, S., Nazeer, A., Hussain, I., & Ibrahim, M. (2018). Factors Affecting Dermatological Manifestations in Patients with End Stage Renal Disease. Journal of the College of Physicians and Surgeons, 28(2), 98–102. https://doi.org/10.29271/jcpsp.2018.02.98
Asokan, S., Narasimhan, M., & V., R. (2017). Cutaneous manifestations in chronic renal failure patients on hemodialysis and medical management. International Journal of Research in Dermatology, 3(1), 24–32. https://doi.org/10.18203/issn.2455-4529.intjresdermatol20170432
Bernardi, L., Souza, B. C., Sonda, N. C., Visioli, F., Rados, P. V., & Lamers, M. L. (2018). Effects of Diabetes and Hypertension on Oral Mucosa and TGFβ1 Salivary Levels. Brazilian Dental Journal, 29(3), 309–315. https://doi.org/10.1590/0103-6440201801868
Blaha, T., Nigwekar, S., Combs, S., Kaw, U., Krishnappa, V., & Raina, R. (2018). Dermatologic manifestations in end stage renal disease. Hemodialysis International, 23(1), 3–18. https://doi.org/10.1111/hdi.12689
Dande, R., Gadbail, A. R., Sarode, S., Gadbail, M. P. M., Gondivkar, S. M., Gawande, M., Sarode, S. C., Sarode, G. S., & Patil, S. (2018). Oral Manifestations in Diabetic and Nondiabetic Chronic Renal Failure Patients receiving Hemodialysis. The Journal of Contemporary Dental Practice, 19(4), 398–403. https://doi.org/10.5005/jp-journals-10024-2273
Deshmukh, S., Sharma, Y., Chaudhari, N., Dash, K., & Deo, K. (2013). Clinicoepidemiological study of skin manifestations in patients of chronic renal failure on hemodialysis. Indian Dermatology Online Journal, 4(1), 18–21. https://doi.org/10.4103/2229-5178.105458
Douglas, C. (2014). Palliative care for patients with advanced chronic kidney disease. The Journal of the Royal College of Physicians of Edinburgh, 44(3), 224–231. https://doi.org/10.4997/jrcpe.2014.309
El-Domyati, M. M., Ahmad, H. M., Nagy, I., & Zahran, A. (2007). Expression of apoptosis regulatory proteins p53 and Bcl-2 in skin of patients with chronic renal failure on maintenance haemodialysis. Journal of the European Academy of Dermatology and Venereology, 21(6), 795–801. https://doi.org/10.1111/j.1468-3083.2006.02090.x
Eltas, A., Tozoğlu, Ü., Keleş, M., & Canakci, V. (2012). Assessment of Oral Health in Peritoneal Dialysis Patients With and Without Diabetes Mellitus. Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 32(1), 81–85. https://doi.org/10.3747/pdi.2010.00113
Escamilla, D. A., Lakhani, A., Antony, S., Villegas, K. N. S., Gupta, M., Ramnath, P., Pineda, M. I. M., Bedor, A., Banegas, D., & Martinez, E. C. (2024). Dermatological Manifestations in Patients With Chronic Kidney Disease: A Review. Cureus, 16(1), e52253. https://doi.org/10.7759/cureus.52253
Falodun, O., Ogunbiyi, A., Salako, B., & George, A. K. (2011). Skin changes in patients with chronic renal failure. Saudi Journal of Kidney Diseases and Transplantation, 22(2), 268–272. https://pubmed.ncbi.nlm.nih.gov/21422624/
Gega, M., Vasili, E., & Resuli, M. (2014). Skin Changes among Patients with Chronic Kidney Disease on Predialysis and Maintenance Haemodyalisis. International Journal of Science and Research, 3(12), 1707–1710. https://www.ijsr.net/archive/v3i12/U1VCMTQ4NjY=.pdf
Goel, V., Sil, A., & Das, A. (2021). Cutaneous Manifestations of Chronic Kidney Disease, Dialysis and Post-Renal Transplant: A Review. Indian Journal of Dermatology, 66(1), 3–11. https://doi.org/10.4103/ijd.IJD_502_20
Guggenheimer, J., & Moore, P. A. (2003). Xerostomia. The Journal of the American Dental Association, 134(1), 61–69. https://doi.org/10.14219/jada.archive.2003.0018
Gunipudi, S. K., Srirama, S., Siddabathuni, N., Cheedirala, R. M, & Talluru, V. A clinical study of cutaneous manifestations in patients with chronic kidney disease. Journal of Dental and Medical Sciences, 14(10), 7–17. https://doi.org/10.9790/0853-1410110717
Hu, X., Sang, Y., Yang, M., Chen, X., & Tang, W. (2018). Prevalence of chronic kidney disease-associated pruritus among adult dialysis patients. Medicine, 97(21), e10633. https://doi.org/10.1097/md.0000000000010633
Jameson, J. L., & Loscalzo, J. (2014). Nefrologia e Distúrbios Acidobásicos de Harrison (2ª edição). AMGH.
Jiang, X., Ji, F., Chen, Z.-W., & Huang, Q.-L. (2016). Comparison of high-flux hemodialysis with hemodialysis filtration in treatment of uraemic pruritus: a randomized controlled trial. International Urology and Nephrology, 48(9), 1533–1541. https://doi.org/10.1007/s11255-016-1364-2
Kadam, M., & Kadam, P. (2018). Study of dermatological manifestations amongst patients with chronic kidney disease. International Journal of Research in Dermatology, 4(4), 543–549. https://doi.org/10.18203/issn.2455-4529.intjresdermatol20184458
Khajuria, R., Singh, K., & Rahim, G. (2016). Dermatological Manifestations in Patients with Chronic Renal Failurea: A Clinicopathological Study. JK SCIENCE, 18(3), 166–171. https://www.jkscience.org/archives/volume183/12-Original%20Article.pdf
Khare, A., & Gulanikar, A. (2020). A Clinical Study of Cutaneous Manifestations in Patients with Chronic Kidney Disease on Conservative Management, Hemodialysis, and Renal Transplant Recipient. Clinical Dermatology Review, 4(1), 23–30. https://doi.org/10.4103/cdr.cdr_59_18
Merchán-Hamann, E., & Tauil, P. L. (2021). Proposta de classificação dos diferentes tipos de estudos epidemiológicos descritivos. Epidemiologia e Serviços de Saúde, 30(1), 1–13. https://doi.org/10.1590/s1679-49742021000100026
National Kidney Foundation. (2015). KDOQI Clinical Practice Guideline for Hemodialysis Adequacy: 2015 Update. American Journal of Kidney Diseases, 66(5), 884–930. https://doi.org/10.1053/j.ajkd.2015.07.015
Nisa, L., & Giger, R. (2012). Lingua plicata. Canadian Medical Association Journal, 184(4). https://doi.org/10.1503/cmaj.111255
Peres, L. A. B., Passarini, S. R., Branco, M. F. B. T., & Kruger, L. A. (2014). Skin lesions in chronic renal dialysis. Brazilian Journal of Nephrology, 36(1), 42–47. https://doi.org/10.5935/0101-2800.20140008
Picó, M. R., Lugo-Somolinos, A., Sánchez, J. L., & Burgos-Calderón, R. (1992). Cutaneous alterations in patients with chronic renal failure. International Journal of Dermatology, 31(12), 860–863. https://doi.org/10.1111/j.1365-4362.1992.tb03543.x
Pradhan, M., Chettri, G., Rai, D., & Paudel, S. (2018). Cutaneous Manifestations in Patients with Chronic Kidney Disease on Hemodialysis and its Correlation with Renal Function, Dialysis Cycle and Haemoglobin. Birat Journal of Health Sciences, 3(2), 468–474. https://doi.org/10.3126/bjhs.v3i2.20963
Rashpa, R. S., Mahajan, V. K., Kumar, P., Mehta, K. S., Chauhan, P. S., Rawat, R., & Sharma, V. (2018). Mucocutaneous manifestations in patients with chronic kidney disease: A cross-sectional study. Indian Dermatology Online Journal, 9(1), 20–20. https://doi.org/10.4103/idoj.idoj_160_17
Sanad, E. M., Sorour, N. E., Saudi, W. M., & Elmasry, A. M. (2014). Prevalence of cutaneous manifestations in chronic renal failure patients on regular hemodialysis: a hospital-based study. Egyptian Journal of Dermatology and Venerology, 34(1), 27–35. https://doi.org/10.4103/1110-6530.137278
Saray, Y., Seçkin, D., Güleç, A. T., Akgün, S., & Haberal, M. (2004). Nail disorders in hemodialysis patients and renal transplant recipients: a case-control study. Journal of the American Academy of Dermatology, 50(2), 197–202. https://doi.org/10.1016/j.jaad.2003.07.014
Schmalz, G., Schiffers, N., Schwabe, S., Vasko, R., Müller, G. A., Haak, R., Mausberg, R. F., & Ziebolz, D. (2017). Dental and periodontal health, and microbiological and salivary conditions in patients with or without diabetes undergoing haemodialysis. International Dental Journal, 67(3), 186–193. https://doi.org/10.1111/idj.12282
Shaikh, I. M., & Chandravathi, P. L. (2016). Epidemiological Study of Cutaneous Manifestations in Patients with Chronic Kidney Disease. Journal of Medical Science and Clinical Research, 4(7), 11392–11398. http://dx.doi.org/10.18535/jmscr/v4i7.34
Shaikh, Z. A., Hussain Shah, A., Kumar, A., Shaikh, I. A., Shaikh, B. A., & Kumar Ahuja, K. (2019). Skin manifestations in end stage renal disease patients on hemodialysis. The Professional Medical Journal, 26(10), 1678–1681. https://doi.org/10.29309/tpmj/2019.26.10.3390
Silva, M. F. A., Barbosa, K. G. N., Pereira, J. V., Bento, P. M., Godoy, G. P., & Gomes, D. Q. C. (2015). Prevalence of oral mucosal lesions among patients with diabetes mellitus types 1 and 2. Anais Brasileiros de Dermatologia, 90(1), 49–53. https://doi.org/10.1590/abd1806-4841.20153089
Tameezuddin, A., Malik, I. J., Arshad, D., Tameezuddin, A., Noman, A. C., & Asad, Z. (2023). Frequency and Effect of Cutaneous Manifestations on Quality of Life in Patients with End-Stage Renal Disease Undergoing Hemodialysis. Journal of the College of Physicians & Surgeons Pakistan, 33(4), 406–410. https://doi.org/10.29271/jcpsp.2023.04.406
Thomas, E., Thomas, A., & Pawar, B. (2012). A prospective study of cutaneous abnormalities in patients with chronic kidney disease. Indian Journal of Nephrology, 22(2), 116–120. https://doi.org/10.4103/0971-4065.97127
Udayakumar, P., Balasubramanian, S., Ramalingam, K. S., Lakshmi, Srinivas, C. R., & Mathew, A. C. (2006). Cutaneous manifestations in patients with chronic renal failure on hemodialysis. Indian Journal of Dermatology, Venereology and Leprology, 72(2), 119–125. https://doi.org/10.4103/0378-6323.25636
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Caroline Barreto Cavalcanti; Camilla Gatto de Oliveira Thomé; Patrícia Kimura de Lima Name
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.