Profile of Skin Manifestations in Chronic Kidney Failure Patients with Hemodialysis and Non-Hemodialysis in Universitas Sumatera Utara Hospital Medan

Abstract

Introduction: The skin and kidney constitute two main organ system in the human body, which partner many important functions and can occur in various diseases. In chronic kidney failure (CKF) generally shows skin manifestations associated with impaired kidney function. Objective: To determine the description of skin disorders in CKF on hemodialysis and medical management, nonhemodialysis. Methods: A descriptive study with cross-sectional design involving 86 subjects, including 43 each in maintenance hemodialysis and non-hemodialysis group. A detailed history was taken and complete dermatological examination was performed. Special investigations KOH mount for fungal, Tzank smear and skin biopsies were performed when clinically indicated. Results: Total 86 subjects, 43 subjects with chronic kidney failure with hemodialysis and 43 subjects nonhemodialysis with the highest proportion was men (66.3%), the most distribution in the age group> 56 years (46.51%). The most common underlying disease lead to CKF was diabetic nephropathy (52.3%). The common nonspecific skin manifestations observed were xerosis in 73.2% (hemodialysis 44.18%, non-hemodialysis 29.06%), pruritus in 68.6% (hemodialysis 43.03%, non-hemodialysis 25.58%) with moderate pruritus 26.7%, hyperpigmentation in 59.3% (hemodialysis 40.69%), non-hemodialysis 17.60%). Nail changes were observed in 54.6% (hemodialysis 39.53%), nonhemodialysis 15.11%). Hair changes in 15.11% (hemodialysis 12.79%, non-hemodialysis 2.32%). Puncture marks were found 27.90% of the hemodialysis patients. Conclusion: Skin manifestations that found in CKF with hemodialysis and non-hemodialysis, frequent in nonspecific skin manifestations were xerosis, pruritus, hyperpigmentation, half-half nails, telogen effluvium and xerostomia. The specific skin manifestations were infections.