Published: 2017-03-28

Cutaneous manifestations in patients with chronic kidney diseases on haemodialysis

Nekram Baghel, Sankalp Awasthi, Sweta S. Kumar


Background: Cutaneous and mucosal disorders are of the common problems in patients on long term haemodialysis. The aim of this study was to evaluate the frequency and nature of cutaneous lesions among patients with chronic kidney diseases who received maintenance haemodialysis.

Methods: Eighty patients with chronic kidney diseases on haemodialysis were studied. All of the patients were fully examined for cutaneous, hair, nail and mucosal changes. Diagnostic measures such as scraping and biopsy of the lesions was carried out, where necessary.

Results: The patients were 30 females and 50 males with a mean age of 47.6 years. The duration of haemodialysis was 36±11 months. All patients included in this study had at least one cutaneous manifestation attributable to CRF. The most prevalent findings were xerosis (66.2%) followed by pallor (57.5%), pruritus (51.25%), infections (33.75%), AV shunt dermatitis (16.25%), pigmentary changes (13.75%), purpura, ecchymoses (8.75%) and perforating disorders (2.5%). Hair changes were diffuse alopecia (16.25%), brittles, lustreless hair (3.75%) and sparse body hairs (1.25%). Oral changes were candidiasis (10%), angular cheilitis (3.75%), gingivitis (2.75%), fissured tongue (2.75%) and lichen planus (1.25%). Nail changes were leukonychia (10%), dystrophic nails (7.5%) onychomycosis (6.25%), subungual hyperkeratosis (5%) and half and half nails (1.25%).

Conclusions: At least one cutaneous manifestation is found in all CRF patients. The etiology of CRF does not affect the cutaneous, hair or nail abnormalities. Factors such as diagnostic climate and early treatment influence some disorders such as xerosis, pruritus and infections.


Chronic kidney disease, Digit gigantism, Haemodialysis

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Mazuryk HA, Brodkin RH. Cutaneous clues to renal disease. Cutis. 1991;47:241-8.

Abdelbaqi-Salhab M, Shalhub S, Morgan MB. A current review of the cutaneous manifestations of renal disease. J Cutan Pathol. 2003;30:527-38.

Bencini PL, Montagnino G, Citterio A, Graziani G, Crosti C, Ponticelli C. Cutaneous abnormalities in uremic patients. Nephron. 1985;40:316-21.

Udayakumar P, Balasubramanian S, Ramalingam KS. Cutaneous manifestations in patients with chronic renal failure on haemodialysis. Indian J Dermatol Venereol Leprol. 2006;72:119-25.

Singh G, Verma AV, Singh G, Singh SJ. Cutaneous changes in chronic renal failure. Ind J Dermatol Venerol Leprol. 1998;58:320-2.

Hajheydari Z, Makhlough A. Cutaneous and mucosal manifestations in patients on maintenance haemodialysis. Iran J Kidney Dis. 2008;2:86-90.

Tawade YV, Gokhale BB. Dermatological manifestations of chronic renal failure. Ind J Dermatol Venerol Leprol. 1996;62:155-6.

Pico MR, Lugo-Somolinos A, Sanchez JL, Calderon BR. Cutaneous alteration in patients with chronic renal failure. Int J Dermatol. 2002;400:860.

Gilchrest BA, Rowe JW. Cutaneous aspects of renal disease. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz S, eds. Fitzpatrick’s Dermatology in general medicine, 3rd edition. New York: Me Graw hill Inc; 1993:1980-1997.

Etter L, Myers SA. Pruritus in systemic disease: Mechanisms and management. Dermatol Clin. 2002;20(3):459-72.

Imazu LE, Tachibana T, Danno K, Tanaka M, Imamura S. Histamine-releasing factor(s) in sera of uremic pruritus patients in a possible mechanism of UVB therapy. Arch Dermatol Res. 1993;285(7):423-7.

Chargin L, Keil H, Skin diseases in non-surgical renal disease. Arch Dermatolsyphiiol. 1932;26:314-35.

Dyachenko P, Shustak A, Rozenman D. Haemodialysis related pruritus and associated cutaneous manifestation. Int J Dermatol. 2006;45(6):664-7.

Remmuzi G. Bleeding in renal failure. Lancet. 1988;1:1205-8.

Hood AF, Hardegen GL, Zarate AR, Nigra TP, Gelfand MC. Kyrle’s disease in patients with chronic renal failure. Arch Dermatol. 1982;118(2):85.

Morton CA, Henderson IS, Jones MC, Lowe JG. Acquired perforating dermatosis in a British dialysis. Br J Dermatol. 1996;135(5):671.

Chargin L, Keil H, Skin diseases in non-surgical renal disease. Arch Dermatolsyphiiol.1932;26:314-35.

Altmeyer P, Kachel HG, Junger M, Koch KM, Holzmann H. Skin changes in long term dialysis patients. Hautarzt. 1982;33:137-42.