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慢性肾脏病患儿的皮肤屏障功能紊乱。

Disturbed skin barrier in children with chronic kidney disease.

作者信息

Wojtowicz-Prus Elzbieta, Kilis-Pstrusinska Katarzyna, Reich Adam, Zachwieja Katarzyna, Miklaszewska Monika, Szczepanska Maria, Szepietowski Jacek C

机构信息

Department of Dermatology, Regional Specialist Hospital, Center for Research and Development, Wroclaw, Poland.

出版信息

Pediatr Nephrol. 2015 Feb;30(2):333-8. doi: 10.1007/s00467-014-2932-2. Epub 2014 Aug 17.

Abstract

BACKGROUND

There are limited data on skin lesions in children with end-stage renal failure. The aim of the study was an evaluation of the skin barrier in children with different stages of chronic kidney disease (CKD). The prevalence of xerosis, its severity, as well as its link selected demographic factors, were examined.

METHODS

The study included 103 children: 72 with CKD stages 3-5 (38 on conservative treatment and 34 on dialysis) and 31 patients with primary monosymptomatic nocturnal enuresis as a control group. Initially, the study subjects described the localisation and severity of dry skin by themselves. Next, clinical evaluation of xerosis, non-invasive corneometric assessment of epidermis moisturising and the measurement of transepidermal water loss were performed.

RESULTS

Most CKD children reported dry skin. The problem of xerosis was identified more frequently in patients on dialysis (67.6 %) than on conservative treatment (42.1 %) (p = 0.01). CKD patients divided according to skin dryness did not differ with regards to age, sex, initial kidney disease and CKD duration.

CONCLUSIONS

Disturbed skin barrier is an important concern of children with CKD, intensifying as the disease progresses. This symptom occurs on early stages of CKD and it should be taken into consideration in the CKD management.

摘要

背景

关于终末期肾衰竭患儿皮肤病变的数据有限。本研究的目的是评估不同阶段慢性肾脏病(CKD)患儿的皮肤屏障功能。研究了皮肤干燥症的患病率、严重程度及其与选定人口统计学因素的关系。

方法

本研究纳入103名儿童:72名CKD 3 - 5期患儿(38名接受保守治疗,34名接受透析),以及31名原发性单纯性夜间遗尿症患儿作为对照组。最初,研究对象自行描述干性皮肤的部位和严重程度。接下来,进行了皮肤干燥症的临床评估、表皮保湿的无创角质层测量以及经表皮水分流失的测量。

结果

大多数CKD患儿报告有皮肤干燥。透析患者中皮肤干燥症问题的发生率(67.6%)高于保守治疗患者(42.1%)(p = 0.01)。根据皮肤干燥程度划分的CKD患者在年龄、性别、初始肾病和CKD病程方面无差异。

结论

皮肤屏障功能紊乱是CKD患儿的一个重要问题,且随着疾病进展而加剧。这种症状在CKD早期就会出现,在CKD管理中应予以考虑。

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