Solak B, Acikgoz S B, Sipahi S, Erdem T
Department of Dermatology, School of Medicine, Sakarya University, Sakarya, Turkey.
Department of Internal Medicine, School of Medicine, Sakarya University, Sakarya, Turkey.
J Eur Acad Dermatol Venereol. 2016 Sep;30(9):1609-13. doi: 10.1111/jdv.13643. Epub 2016 Mar 30.
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.
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.
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.
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.
在依赖透析的慢性肾脏病（CKD）患者中可见多种皮肤表现。然而，关于透析前CKD患者皮肤表现的小型研究较少。我们旨在确定透析前CKD患者的皮肤表现。
这是一项横断面研究。连续纳入一家大学附属医院肾内科门诊的透析前CKD患者。由一位资深皮肤科医生进行详细的皮肤科检查。对每位参与者进行血尿素、肌酐、乙肝表面抗原和丙肝抗体检测。
本研究共纳入365例连续的透析前CKD患者（2 - 5期）。358例患者（98.1%）至少有一项皮肤表现。最常见的皮肤表现是皮肤干燥（64.9%），其次是毛发表现（41.4%）、瘙痒（19.2%）、色素沉着改变（17.5%）、指甲表现（15.3%）和口腔黏膜表现（9.3%）。纵向条纹是最常见的指甲表现，弥漫性棕色色素沉着是最常见的色素沉着改变，舌苔增厚是最常见的口腔黏膜表现，雄激素性脱发是最常见的毛发表现。皮肤表现的频率和多样性在CKD各阶段无变化。
这是在特征明确的透析前CKD患者群体中调查皮肤表现的最大规模研究。我们发现几乎所有CKD患者都至少有一项皮肤表现。透析前CKD患者的皮肤表现非常常见且多样。
