Skin Changes, Frequencies and Associated Factors in Maintanence Hemodialysis Patients: Single Center Experience

Yıl 2022, Cilt: 17 Sayı: 2, 134 - 139, 15.07.2022

Eda Altun

https://doi.org/10.17517/ksutfd.1096741

Öz

Objective: In this study, we aimed to evaluated to the prevalance of skin lesions among patients with undergoing hemodialysis and to determine their relations with dialysis adequacy, time of hemodialysis and co-morbid diseases.
Material and Methods: Two hundred forty four hemodialysis patients were included in the study. Patients was examined by a volunteer dermatologist during their monthly pyhsical examinations. All other data were recorded retrospectively from hospital record system.
Results: The patients were 102 (42%) women and 142 (58%) men with a mean age of 58.0±18.2 years. The median duration of hemodialysis was 4.2 years. The most common skin finding was xerosis, which was present in 60.6% of the patients. Other common skin findings were pruritis (53%), hair reduction
(49.5%), hair changes (47.9%), nail changes (42.5%), eczema (20.9%), and hyperpigmentation (8.6%), in order of frequency. Xerosis was more commonly found in diabetic patients than non-diabetic. (p<0.001). A significant relationship was seen between dialysis adequacy (Kt/V) and pruritis and xerosis (p=0.01).
There was no significant correlations between skin lesions and Calcium (Ca), phospour (P), CaXP, parathormon (PTH) ferritin or albumin. The rate of onychomycosis included in the nail changes category was found to be statistically significantly higher in the diabetic patient group than in the non-diabetic patient group (p=0.01). Premalignant and malign skin lesions were detected in 7 patients in the diabetic group and in 2 patients in the non-diabetic group.
Conclusion: Skin lesions are common in CRF patients, and although the prevalence of skin lesions, it has been showed that in many studies, as in our study, that xerosis and pruritis are the most common in both predialysis and dialysis patients. A detailed dermatological examination may play an important role in
the diagnosis of skin lesions earlier and this increased of quality of life in patients.

Anahtar Kelimeler

Chronic renal failure, Hair, Hemodialysis, Nail, Skin

Hemodiyaliz Tedavisine Devam Eden Hastalarda Cilt Lezyonlarının Sıklığı ve İlişkili Faktörler: Tek Merkez Deneyimi

Öz

Amaç: Bu çalışmada diyaliz tedavi programındaki hastalarda cilt lezyonlarının sıklığını, cilt lezyonlarının tedavi süresi, diyaliz yeterliliği, altta yatan hastalık ile ilişkisinin varlığını saptamayı amaçladık.
Gereç ve Yöntemler: Çalışmaya 244 hemodiyaliz hastası dâhil edildi. Hastalar aylık muayeneleri yapılırken gönüllü dermatoloji uzmanı tarafından muayene edildi. Veriler dosyalarından retrospektif olarak kaydedildi.
Bulgular: Çalışmaya yaş ortalaması 58±18.2 olan 244 (%58 erkek, % 42 kadın) hasta alındı. Ortalama hemodiyaliz tedavi süresi 4.2 yıldı. En sık cilt bulgusu kserozis olup hastaların %60.6’sında mevcuttu. Diğer sık görülen cilt bulguları ise sıklık sırası ile pruritis (%53), kıllarda azalma (%49.5), saç değişiklikleri
(%47.9), tırnak değişiklikleri (%42.5), ekzema (%20.9) ve hiperpigmentasyon (%8.6) olarak saptandı. Kserozis sıklığı diyabetik hasta grubunda non-diyabetik hastalara göre daha fazlaydı (p<0.001). Hastalarda saptanan cilt lezyonlarından pruritis ve kserozis ile diyaliz yeterliliği arasında (Kt/V) istatistiksel anlamlı korelasyon olduğu saptanırken (p=0.01), kalsiyum (Ca), fosfor (P), CaxP, parathormon (PTH), ferritin, albümin düzeyleri ile istatistiksel anlamlı korelasyon saptanmadı. Diyabetik ve diyabetik olmayan hastalar karşılaştırıldığında ise pruritis oranının diyabetik hasta grubunda istatistiksel anlamlı olarak daha yüksek olduğu saptandı (p=0.01). Tırnak değişiklikleri kategorisine dâhil edilen onikomikoz oranının diyabetik hasta grubunda non-diyabetik hasta grubundan istatistiksel anlamlı olarak daha yüksek oranda gözlendiği saptandı (p=0.01). Diyabetik hasta grubunda 7, diyabetik olmayan grupta ise 2 hastada olası premalign lezyon tespit edildi.
Sonuç: KBY hastalarında cilt lezyonları yaygın olarak görülmekte, cilt bulgularının prevalansı farklılık göstermekle birlikte hem prediyaliz hemde diyaliz hastalarında en sık kserozis ve pruritis olduğu bizim çalışmamızda olduğu gibi birçok çalışmada gösterilmiştir. Hemodiyaliz hasta grubunda sık karşılaşılan
cilt lezyonlarının tanınması erken tanı ve tedavi olanağı sağlayarak hastaların yaşam kalitesini artıracaktır.

Anahtar Kelimeler

Cilt, Hemodiyaliz, Kronik böbrek yetmezliği, Saç, Tırnak

Kaynakça

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