Evaluation of dermatological manifestations in patients with chronic kidney disease in a hemodialysis service in the Federal District

Authors

DOI:

https://doi.org/10.33448/rsd-v13i3.45208

Keywords:

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

Published

07/03/2024

How to Cite

CAVALCANTI, C. B. .; THOMÉ, C. G. de O. .; NAME, P. K. de L. . Evaluation of dermatological manifestations in patients with chronic kidney disease in a hemodialysis service in the Federal District. Research, Society and Development, [S. l.], v. 13, n. 3, p. e0913345208, 2024. DOI: 10.33448/rsd-v13i3.45208. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/45208. Acesso em: 15 jun. 2024.

Issue

Section

Health Sciences