Cutaneuos Findings in Patients with Predialysis Chronic Kidney Disease

Background: Several cutaneous findings are seen in dialysis dependent chronic kidney disease (CKD) patients. However, there are only a few small studies on cutaneous findings in predialysis CKD patients. We aimed to determine cutaneous findings in predialysis CKD patients.

Methods: This was a cross-sectional study. Consecutive predialysis CKD patients from nephrology outpatient clinic in a university affiliated hospital were recruited to this study. Detailed dermatologic examination was performed by a senior dermatologist. Blood urea, creatinine, hepatitis B surface antigen and hepatitis C antibody test were studied for each participant.

Results: A total of 365 consecutive predialysis CKD patients (stages 2-5) included in the study. Three hundred and fifty-eight patients (98.1%) had at least one dermatologic finding. The most common cutaneous finding was xerosis (64.9%) followed by hair findings (41.4%), pruritus (19.2%), pigmentary changes (17.5%), nail findings (15.3%) and oral mucosal findings (9.3%). Longitudinal striations was the most common nail finding, diffuse brown hyperpigmentation was the most common pigmentary change, coated tongue was the most common oral mucosal finding and androgenetic alopecia was the most common hair finding. Frequency and diversity of dermatologic findings did not change across CKD stages.

Conclusions: This is the largest study investigating dermatologic findings in a well-characterized predialysis CKD patient population. We found that at least one cutaneous finding was present in almost all of the CKD patients. Cutaneous findings are very common and diverse among predialysis CKD patients.