Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Dermatology, Venerology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Clin Exp Dermatol. 2021 Oct;46(7):1270-1276. doi: 10.1111/ced.14708. Epub 2021 Jun 24.
Dermatological manifestations due to impaired renal function in children with chronic kidney disease (CKD) are diverse and are an important cause of morbidity.
To determine the prevalence of dermatological manifestations in predialysis children with different stages of CKD and its association with various metabolic parameters.
This cross-sectional observational study was conducted in 200 predialysis children with CKD stages 1-5 and 200 age- and sex-matched healthy controls (HCs). Detailed dermatological examination was performed to check for any pathological/physiological changes in the skin, mucosa, hair and nails, and changes were recorded in a predesigned proforma.
The median age of cases and HCs was 60.50 months (76.5% males) and 62 months (78.5% males) respectively. Skin manifestations were seen in 189 (94.5%) cases and 156 (78%) HCs (P < 0.001). The most common skin manifestation among cases was pallor (75.5%, P < 0.001) followed by xerosis (48.5%, P < 0.001), atopic diathesis (41.5%) and pruritus (13%, P < 0.001), while among HCs, the most common skin manifestation was atopic diathesis (46%), followed by pallor (24%) and xerosis (14%). Xerosis was found to be significantly associated with higher serum creatinine levels (P = 0.04) and hypocalcaemia (P = 0.03). There was no significant association found between pruritus and serum creatinine.
Xerosis was significantly associated with higher levels of creatinine and hypocalcaemia. Timely recognition of these symptoms and proper management can improve the quality of life in children with CKD.
患有慢性肾脏病（CKD）的儿童由于肾功能受损而出现的皮肤表现多种多样，是发病率的重要原因。
确定不同 CKD 分期的透析前儿童中皮肤病的患病率及其与各种代谢参数的关系。
这是一项横断面观察性研究，共纳入 200 名 CKD 1-5 期的透析前儿童和 200 名年龄和性别匹配的健康对照者（HCs）。对皮肤、黏膜、毛发和指甲进行详细的皮肤检查，以检查任何病理性/生理性变化，并将变化记录在预先设计的表格中。
病例和 HCs 的中位年龄分别为 60.50 个月（76.5%为男性）和 62 个月（78.5%为男性）。189 例（94.5%）病例和 156 例（78%）HCs 出现皮肤表现（P<0.001）。病例中最常见的皮肤表现是苍白（75.5%，P<0.001），其次是干燥（48.5%，P<0.001）、特应性素质（41.5%）和瘙痒（13%，P<0.001），而 HCs 中最常见的皮肤表现是特应性素质（46%），其次是苍白（24%）和干燥（14%）。干燥与血清肌酐水平升高（P=0.04）和低钙血症（P=0.03）显著相关。瘙痒与血清肌酐之间无显著相关性。
干燥与肌酐和低钙血症水平显著相关。及时识别这些症状并进行适当的治疗可以提高 CKD 儿童的生活质量。
