European Journal of Cardiovascular Medicine

Background: Chronic renal failure (CRF) is manifested by various skin symptoms. New changes have been described continuously since the advent of hemodialysis, which increases life expectancy and allows time for these changes to occur. Objective: The aim of this study was to determine the frequency of skin manifestations in chronic renal failure (CRF) patients receiving hemodialysis.  Methods: it was a cross sectional observational study in which skin changes were studied in a total of 500 CRF patientsreceiving hemodialysis attending dermatology OPD in a tertiary hospital in central India.  Results: 80% of the patients complained of some skin problems.However, at examination, all patients had at least one skin condition caused by CRF. The most common finding was xerosis (80%), followed by pallor (70%), itching (50%), and skin hyperpigmentation (40%). Other skin manifestations include Kell's disease (20%), fungal (40%), bacterial (15%),  purpura (10%) and dermatitis (2%). Nail changes include koilonychia (25%), onychomycosis (20%), subungual hyperkeratosis (10%), onycholysis (10%) and hemorrhages (5%), Mee’s line (5%), Muehrcke lines (5%) and Beau's lines (2%). Hair changes include thinning hair (35%) and brittle and dull hair (15%). Oral changes include striated macroglossia (40%), xerostomia (30%), ulcerative stomatitis (30%), angular cheilitis (15%), and uremic breath (10%). Some rare side effects of CRF have also been observed, such as uremic frostbite, gynecomastia, and pseudoKaposi's sarcoma.  Conclusion: CRF is associated with a complex set of cutaneous manifestations caused by disease or treatment. The most common are xerosis and pruritus, and early recognition of skin symptoms can reduce pain and morbidity.