Comparison Of The Prevalence And Severity Of Cutaneous Manifestations In Dialysis And Non-Dialysis Patients With Chronic Kidney Disease

Abstract

Background: Chronic kidney disease (CKD) is a global public health problem associated with numerous systemic complications, including cutaneous manifestations. Skin changes often reflect underlying renal pathology and may affect quality of life. The prevalence and severity of these dermatological abnormalities may differ between dialysis and non-dialysis CKD patients. Objective: To compare the prevalence and severity of cutaneous manifestations in CKD patients receiving maintenance haemodialysis (MHD) versus without dialysis. Materials and Methods: This cross-sectional study was conducted in the Department of Dermatology & Venereology and Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh and International Medical College, Tongi, Gazipur, Bangladesh from January 2022 to June 2022. Eighty adult CKD patients (stages III–V) were recruited, divided equally into two groups: 40 on MHD and 40 without dialysis. Exclusion criteria included acute kidney injury, previous kidney transplantation, and pre-existing dermatological conditions. Demographic, clinical, and laboratory data were recorded. Cutaneous manifestations were assessed based on clinical findings and, when necessary, confirmed through laboratory investigations. Statistical analysis was performed using Chi-square and unpaired Student’s t tests, with p<0.05 considered significant. Results: Among 80 patients, males predominated (66.3%) with a mean age of 44.6 years. Cutaneous abnormalities were significantly more common in dialysis patients, including xerosis, pruritus, purpura/ecchymosis, infections, ulcerative stomatitis, and half-and-half nails (all p < 0.05). In pre-dialysis CKD, skin changes increased with stage, with pallor, xerosis, pruritus, half-and-half nails, pigmentation, and infections most frequent in Stage V. Overall, abnormalities were markedly more prevalent in advanced CKD and dialysis patients. Conclusion: Cutaneous manifestations are highly prevalent among CKD patients and are more severe in those undergoing dialysis. Early recognition of these dermatological changes may aid in timely diagnosis, management, and improved quality of life for CKD patients.