MD, Masters Student. Dermatologist, Attending physician, Dermatology Outpatient Clinic, Hospital das Clínicas, Universidade Federal de Minas Gerais / Empresa Brasileira de Serviços Hospitalares (UFMG/EBSERH) Belo Horizonte (MG), Brazil.
MD, PhD. Associate Professor, Department of Internal Medicine, Medical School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil; Coordinator of Scientific Division, Telehealth Network of Minas Gerais, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
Sao Paulo Med J. 2024 Feb 23;142(4):2023148. doi: 10.1590/1516-3180.2023.0148.R1.29112023. eCollection 2024.
The prevalence of chronic kidney disease (CKD) has increased in the recent decades, along with the number of patients in the terminal stages of this disease, requiring transplantation. Some skin disorders are more frequent in patients with CKD and in renal transplant recipients (RTR).
To evaluate the frequency of skin diseases in RTR and patients with CKD receiving conservative treatment.
This observational cross-sectional study recruited consecutive patients with CKD and RTR from a nephrology clinic at a teaching hospital in Brazil between 2015 and 2020.
Quantitative, descriptive, and analytical approaches were used. The sample was selected based on convenience sampling. Data were collected from dermatological visits and participants' medical records.
Overall, 308 participants were included: 206 RTR (66.9%, median age: 48 years, interquartile range [IQR] 38.0-56.0, 63.6% men) and 102 patients with CKD (33.1%, median age: 61.0 years, IQR 50.0-71.2, 48% men). The frequency of infectious skin diseases (39.3% vs. 21.6% P = 0.002) were higher in RTR than in patients with CKD. Neoplastic skin lesions were present in nine (4.4%) RTR and in only one (1.0%) patient with CKD. Among the RTR, the ratio of basal cell carcinoma to squamous cell carcinoma was 2:1.
This study revealed that an increased frequency of infectious skin diseases may be expected in patients who have undergone kidney transplantation. Among skin cancers, BCC is more frequently observed in RTR, especially in those using azathioprine.
近几十年来,慢性肾脏病(CKD)的患病率有所增加,同时需要进行移植的该病终末期患者人数也有所增加。一些皮肤疾病在 CKD 患者和肾移植受者(RTR)中更为常见。
评估 RTR 和接受保守治疗的 CKD 患者中皮肤疾病的频率。
本观察性横断面研究于 2015 年至 2020 年期间在巴西一家教学医院的肾病诊所连续招募了 CKD 和 RTR 患者。
使用定量、描述性和分析方法。根据方便抽样选择样本。数据来自皮肤科就诊和参与者的病历。
共纳入 308 名参与者:206 名 RTR(66.9%,中位数年龄:48 岁,四分位距[IQR] 38.0-56.0,63.6%为男性)和 102 名 CKD 患者(33.1%,中位数年龄:61.0 岁,IQR 50.0-71.2,48%为男性)。RTR 中感染性皮肤疾病的频率(39.3% vs. 21.6% P = 0.002)高于 CKD 患者。9 名(4.4%)RTR 存在肿瘤性皮肤病变,而 CKD 患者中仅 1 名(1.0%)存在此类病变。在 RTR 中,基底细胞癌与鳞状细胞癌的比例为 2:1。
本研究表明,接受过肾移植的患者可能会出现更高频率的感染性皮肤疾病。在皮肤癌中,RTR 中更常观察到基底细胞癌,尤其是在使用硫唑嘌呤的患者中。