Assessment of Skin Manifestations in Patients Undergoing Hemodialysis

Year 2021, Volume: 16 Issue: 1, 1 - 9, 31.01.2021

Harun İn Nazan Akça

https://doi.org/10.47565/ndthdt.2021.27

Abstract

Aim: Cutaneous alterations in patients with hemodialysis are frequently found but were variable. They present
with multiple skin problems that have a significant impact on the quality of life of patients. The article aims to
study the various cutaneous abnormalities and the factors affecting these manifestations in patients undergoing
hemodialysis.
Material and Methods: This study is descriptive and cross-sectional. The sample of the study consisted of 175
patients who met the inclusion criteria and were accepted to participate in the study. Patient information and
questionnaire forms were used in the data collection. The data were collected by the researchers with the face to
face interview.
Results: It was found 73.1% of cases had at least one cutaneous finding attributable to hemodialysis patients and
33.7% of the patients had five skin problems together. The most common skin problems experienced by patients:
Pruritus was observed in 65.1% of cases followed by xerosis (62.9%), pallor and hyperpigmentation (44%), skin
lesion (38.9%), nail change (36.6%), and hair change (48.0%).
Conclusion: Skin, hair and nail changes are common in hemodialysis patients. Dermatological manifestations
increase with increasing duration of hemodialysis. Our observations necessitate a joint effort between and
nephrologists, hemodialysis nurses, and dermatologists for the early recognition and management of these
dermatoses which may reduce the morbidity and significantly improve the quality of life of hemodialysis
patients.

Keywords

Xerozis, Pruritus, Cutaneous manifestations, Hemodialysis

Hemodiyaliz Hastalarında Cilt Sorunlarının Değerlendirilmesi/ Assessment of Skin Manifestations in Patients Undergoing Hemodialysis

Abstract

Amaç: Hemodiyaliz hastalarında cilt problemleri sıklıkla ve değişik
biçimlerde görülmektedir. Hastaların yaşam kalitesi üzerinde önemli
etkisi olan çok sayıda cilt değişiklikleri ile kendini göstermektedir. Bu
çalışma hemodiyaliz hastalarında çeşitli cilt problemlerinin sıklığını ve
etkileyen faktörleri belirlemek amacıyla yapıldı.
Gereç ve Yöntemler: Araştırma tanımlayıcı ve kesitsel tiptedir. Araştırmanın örneklemini, dâhil edilme kriterlerine uyan ve araştırmaya katılmayı kabul eden 175 hasta oluşturdu. Araştırmanın verilerinin toplanmasında hasta tanıtım ve anket formu kullanıldı. Veriler araştırmacılar
tarafından yüz yüze görüşme tekniği ve fiziksel muayene yapılarak
toplandı.
Bulgular: Hastaların %73.1’inin hemodiyaliz tedavisine başladıktan
sonra cilt sorunları yaşadığı ve %33.7’sinde ise beş cilt sorununun birlikte
olduğu saptandı. Hastaların en sık yaşadığı cilt sorunlarına bakıldığında
ise; sırasıyla %65.1 ile kaşıntı, %62.9 cilt kuruluğu, %44 pigment
değişikliği ve solukluk olarak saptandı.
Sonuç: Hemodiyaliz hastalarında cilt, saç ve tırnak değişikliklerinin
yaygın olduğu saptandı. Hemodiyalizin süresi uzadıkça cilt problemleri
artmaktadır. Sonuçlarımız, hemodiyaliz hastalarının morbiditesini azaltabilecek ve yaşam kalitesini önemli ölçüde artırabilecek bu dermatozların
erken tanınması ve tedavisi için nefrologlar ve hemodiyaliz hemşiresi
arasında ortak bir çaba gerektirmektedir.

Keywords

Kuruluk, Kaşıntı, Deri belirtileri, Hemodiyaliz

References

• 1. Karadakovan A, Eti Aslan F. Dâhili ve Cerrahi Hastalıklarda Bakım. Genişletilmiş 3. Baskı. Ankara; Akademisyen Kitabevi; 2014.
• 2. USRDS (2020). USRDS Annual Data Report: Epidemiology of kidney disease in the United States. National Institutes of Health. https://adr.usrds.org/2020. Erişim Tarihi: 25.01.2021
• 3. Süleymanlar G, Ateş K, Seyahi, N. (2020). Türkiyede Nefroloji-Diyaliz ve Transplantasyon Registry 2019. Retrieved from Ankara: http://www.nefroloji.org.tr/folders/file/registry_2019.pdf. Erişim Tarihi:25.01.2021
• 4. Kılıç Akça N. Hemodiyaliz Hastasında Cilt Sorunları ve Bakımı. Türk Nefroloji, Diyaliz ve .Transplantasyon .Dergisi 2019;14(1):26-32.
• 5. Dedeli Çaydan Ö, Çınar Pakyüz S. Hemodiyalizin kronik komplikasyonları ve bakım. Nefroloji Hemşireliği Dergisi 2016;1(1):60-72.
• 6. Ghunawat S, Barman KD, Sarkar R, Garg VK, Alhawat RS. Spectrum of dermatological manifestations in patients with chronic kidney failure. MAMC Journal of Medical Sciences 2015;1(2):96-100.
• 7. Sanai M, Aman S, Nadeem M, Muhammad AH. Dermatologic manifestations in patients of renal disease on hemodialysis. Journal of Pakistan Association of Dermatology 2010;20(1):163-8.
• 8. Udayakumar P, Balasubramanian S, Ramalingam K, Lakshmi C, Srinivas C, Mathew AC. Cutaneous manifestations in patients with chronic renal failure on hemodialysis. Indian Journal of Dermatology, Venereology, and Leprology 2006;2(72):119-25.
• 9. Coulibaly G, Korsaga-Somé N, Yongué Fomena DF, Nagalo Y, Roger Karambiri A, Bassolet A, et al. Les manifestations cutanées chez les patients hémodialysés chroniques dans un pays en voie de développement. Pan African Medical Journal 2016;24(110):2-9.
• 10. Hajheydari Z, Makhlough A. Cutaneous and mucosal manifestations in patients on maintenance hemodialysis. Iranian Journal of Kidney Diseases 2008;2(2):86-90.
• 11. Uphar G, Prasad B. N. R. Cutaneous manıfestatıons ın patıents undergoıng haemodıalysıs for end stage renal dısease. J of Evolution of Med and Dent Sci 2015:5872-6.
• 12. Baghel N, Awasthi S, Sweta SK. Cutaneous manifestations in patients with chronic kidney diseases on haemodialysis. International Journal of Research in Medical Sciences 2017;5(4):1673-8.
• 13. Madiha S, Shahbaz A, Nadeem M, Kazmi AH. Dermatologic manifestations in patients of renal disease on hemodialysis. Journal of Pakistan Association of Dermatologists 2010;20(3):163-8.
• 14. Güder S, Karaca Ş, Kulaç M, Yüksel Ş, Güder H. Afyonkarahisar ve çevresinde diyalize giren kronik böbrek yetmezlikli hastalardaki deri bulguları. Türkderm 2012;46(4):181-5.
• 15. S. Rashpa R, K. Mahajan V, Kumar P, Mehta KS, Chauhan PS, Rawat R, et al. Mucocutaneous manifestations in patients with chronic kidney disease:A Cross‑sectional Study. Indian Dermatology Online Journal 2018;9(1):20-6.
• 16. Altınok Ersoy N, Akyar İ. Multidimensional pruritus assessment in hemodialysis patients. BMC Nephrology 2019;20(42):2-7.
• 17. Kılıç Akça N, Taşçı S. An ımportant problem among hemodialysis patients: uremic pruritus and affecting factors. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 2014;23(3):210-2016.
• 18. Asayesh H, Peykari N, Pavaresh-Masoud M, Esmaeili Abdar M, Tajbakhsh R, Mojtaba Mousavi S, et al. Dermatological manifestations in hemodialysis patients in Iran: A systematic review and meta-analysis. J Cosmet Dermatol 2019;18(1):204-11.
• 19. Mirza R, Wahid Z, Talat H. Dermatological manifestations in chronic renal failure dermatological manifestations in chronic renal failure. Liaquat University of Medical & Health Science 2012;11(1):24-8.
• 20. Levillard DT, Kambil SM. Cutaneous manifestations in chronic renal disease-an observational study of skin changes, new findings, their association with hemodialysis, and their correlation with severity of CKD. International Journal of Scientific and Research Publications 2015;5(3):727-36.
• 21. Salhab MM, Shalhub S, Morgan MB. A current review of the cutaneous manifestations of renal disease. Journal of Cutaneous Pathology. Journal of cutaneous pathology 2003;30(9):527-38.
• 22. Raiesifar Z, Tahery, N, Shirzadegan R, Baraz, S, Darabiyan P, Raiesifar A. Assessment of skin manifestations in endstage renal disease patients undergoing hemodialysis in Shahid Beheshti Hospital of Abadan and Vali-e-Asr Hospital of Khorramshahr. Jundishapur Journal of Chronic Disease Care 2019; 8(1):1-5.
• 23. Sartika D, Putra I. B, Yosi A. Profile of Skin manifestations in chronic kidney failure patients with hemodialysis and non-hemodialysis in universitas Sumatera Utara Hospital Medan. International Journal of Scientific and Research Publications. 2019;9(10):497-500.
• 24. Malkud S, Dyavannanavar V, Varala S. Cutaneous manifestations in patients with chronic kidney disease on hemodialysis. Journal of Pakistan Association of Dermatology. 2020;30(3), 490-496.
• 25. Maskey A, Kumar A, Shrestha R. Study of Cutaneous Manifestations in End Stage Kidney Disease Undergoing Hemodialysis. Nepal Journal of Dermatology, Venereology & Leprology 2020;18(1):37-43.