Altmeyer P, Kachel H G, Jünger M, Koch K M, Holzmann H
Hautarzt. 1982 Jun;33(6):303-9.
Fifty-one regular hemodialysis patients underwent clinicodermatologic examination. Twenty-three of them were on regular hemodialysis for 2-3 years (group I), 28 patients for more than 8 years (group II). Both groups were matched in regard to primary kidney disease, age, and sex. A characteristic feature found was a marked premature aging of the skin, mainly imposing as actinic elastosis. The incidence was related to the duration of hemodialysis (56.5% of patients of the first group and 100% of patients of the second group). There was also a correlation between time on hemodialysis and an increase of skin pigmentation. Other phenomena like xeroderma, decrease of sebaceous and sweat gland secretion, and Raynaud syndrome were also seen more frequently in the second group, but the extent of these alterations was equal in both groups. Seventy-eight percent of the patients of the first group and 43% of the second group suffered from generalized pruritus. Two different froms of pruritus could be observed, one possibly atopic, only occurring during regular hemodialysis, the other occurring independent of hemodialysis. accumulation of rare phenomena like carpal-tunnel syndrome and Dupuytren's contractures in group II together with the frequent occurrence of actinic elastosis implies systemic disturbance of collagen metabolism in long-term regular hemodialysis patients.
51名接受常规血液透析的患者接受了临床皮肤检查。其中23人进行常规血液透析2至3年(第一组),28人透析超过8年(第二组)。两组在原发性肾病、年龄和性别方面相匹配。发现的一个特征性表现是皮肤明显过早老化,主要表现为光化性弹性组织变性。其发生率与血液透析时间有关(第一组患者中有56.5%,第二组患者中有100%)。血液透析时间与皮肤色素沉着增加之间也存在相关性。在第二组中还更频繁地出现其他现象,如皮肤干燥、皮脂腺和汗腺分泌减少以及雷诺综合征,但两组中这些改变的程度相同。第一组78%的患者和第二组43%的患者患有全身性瘙痒。可以观察到两种不同形式的瘙痒,一种可能是特应性的,仅在常规血液透析期间出现,另一种与血液透析无关。第二组中腕管综合征和杜普伊特伦挛缩等罕见现象的积累以及光化性弹性组织变性的频繁发生意味着长期接受常规血液透析的患者存在胶原蛋白代谢的系统性紊乱。