Arriaga Escamilla David, Lakhani Alisha, Antony Sneha, Salazar Villegas Karla N, Gupta Manasvi, Ramnath Parameswaran, Murillo Pineda María Isabel, Bedor Alexandra, Banegas Douglas, Calderon Martinez Ernesto
Internal Medicine, Universidad Justo Sierra, Mexico City, MEX.
Medicine, Research MD, Vadodara, IND.
Cureus. 2024 Jan 14;16(1):e52253. doi: 10.7759/cureus.52253. eCollection 2024 Jan.
Chronic kidney disease (CKD) is a progressive disease and has multiple clinical manifestations; when CKD reaches the end stage, at least one cutaneous manifestation appears due to some increased toxin levels or a constant proinflammatory state. Nonspecific manifestations include pruritus, xerosis, pigmentation disorders, acquired ichthyosis, purpuric spots, and nail disorders. Some specific manifestations are bullous dermatoses, acquired perforating dermatoses (APD), eruptive xanthoma, access site infections, calcifying disorders, and nephrogenic systemic fibrosis (NSF). All these cutaneous changes negatively impact patients; early recognition and diagnosis of these dermatoses will make a difference in their quality of treatment. Exploring a patient's skin is fundamental to suspect some diseases and increased toxin levels; pruritus occurs when uremic toxins are raised, and nail disorders are associated with hypoalbuminemia. This review provides the clinician with information on the clinical manifestations that occur in CKD, including epidemiology, pathophysiology, clinical manifestations, diagnosis, histopathology, treatment, and life impact of the dermatoses in CKD.
慢性肾脏病（CKD）是一种进行性疾病，有多种临床表现；当CKD发展到终末期时，由于某些毒素水平升高或持续的促炎状态，至少会出现一种皮肤表现。非特异性表现包括瘙痒、皮肤干燥、色素沉着紊乱、获得性鱼鳞病、紫癜斑和指甲病变。一些特异性表现为大疱性皮肤病、获得性穿通性皮肤病（APD）、发疹性黄瘤、动静脉内瘘部位感染、钙化紊乱和肾源性系统性纤维化（NSF）。所有这些皮肤变化都会对患者产生负面影响；早期识别和诊断这些皮肤病将对治疗质量产生影响。检查患者的皮肤对于怀疑某些疾病和毒素水平升高至关重要；当尿毒症毒素升高时会出现瘙痒，而指甲病变与低白蛋白血症有关。本综述为临床医生提供了有关CKD中出现的临床表现的信息，包括皮肤病的流行病学、病理生理学、临床表现、诊断、组织病理学、治疗以及对生活的影响。
