Prevalence of cutaneous manifestations and pruritus of end-stage renal disease in patients on hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) at Phramongkutklao Hospital

Vorada Choovichian; Panbubpa Choovichian; Artit Nakakes

Authors

Vorada Choovichian DERMATOLOGY NEPHROLOGY UNIT DEPARTMENT OF INTERNAL MEDICINE PHRAMONGKUTKLAO HOSPITAL, BANGKOK, THAILAND
Panbubpa Choovichian NEPHROLOGY, PHRAMONGKUTKLAO HOSPITAL, BANGKOK, THAILAND
Artit Nakakes DERMATOLOGY NEPHROLOGY UNIT DEPARTMENT OF INTERNAL MEDICINE PHRAMONGKUTKLAO HOSPITAL, BANGKOK, THAILAND

Keywords:

Prevalence, cutaneous manifestations, End-Stage Renal Disease, pruritus

Abstract

Background: Abnormal cutaneous manifestations are common in patients with end-stage renal disease and these problems could have a profound effect on the patients especially pruritus.

Objective: The aim of this study is to determine the prevalence of cutaneous manifestations in patients with end-stage renal disease (ESRD) who are on hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) at Phramongkutklao (PMK) hospital. Pruritus was semi-quantitatively evaluated.

Material and Methods: A cross-sectional survey was conducted during December 2008. All of the 48 patients who were treated with HD (n=18) and CAPD (n=30) at PMK hospital were enrolled. The patients were fully examined for cutaneous, mucosal, nail and hair changes by a single physician. Other laboratory investigations were carried out as necessary. Pruritus was evaluated by pruritus score (using a visual analogue scale).

Results: The prevalence of abnormal cutaneous manifestations was 100%. Xerosis or icthyosis was the most common skin lesion (100%), followed by pruritus (56.3%) and diffuse hyperpigmentation (56.3%). Subungual hyperkeratosis was the most common nail finding (33.3%), followed by Terry’s nail (10.4%), half and half nail (8.3%), onychomycosis (8.3%), pincer nail (8.3%). There were no significant difference in abnormal cutaneous manifestations and pruritus score between HD and CAPD treated groups. Only 41.7% of patients had history of having received advice or treatment from the attending doctors in terms of skin problems that could have happened during dialysis. However, upon comparison to the rest of the patients, there was no significant difference in pruritus score.

Conclusion: Abnormal cutaneous manifestations were extremely common in ESRD patients who are on HD or CAPD. Our study showed xerosis, pruritus and diffuse hyperpigmentation were the top three most common skin findings.

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