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Enfermería Nefrológica

On-line version ISSN 2255-3517Print version ISSN 2254-2884

Abstract

MORILLO-GALLEGO, Noelia; MERINO-MARTINEZ, Rosa Mª; SANCHEZ-CABEZAS, Azahara Mª  and  ALCANTARA-CRESPO, Mateo. Skin alterations in patients with Advanced Chronic Kidney Disease. A systematic review. Enferm Nefrol [online]. 2019, vol.22, n.3, pp.224-238.  Epub Dec 23, 2019. ISSN 2255-3517.  https://dx.doi.org/10.4321/s2254-28842019000300002.

Objective

To know the main alterations of the skin, as well as its prevalence, in patients with Advanced Chronic Kidney Disease.

Material and Method

A systematic review was carried out through searches in the PubMed, Cochrane, Scopus and Google Scholar databases. Scientific articles written in English and Spanish were included. Articles that addressed skin alterations in patients with Advanced Chronic Kidney Disease and/or on dialysis treatment were analyzed.

Results

32 articles published between 2008 and 2018 were included: 7 systematic reviews, 3 intervention studies and 22 observational studies. To a greater or lesser degree, skin disorders appear in most patients on pre-dialysis and on dialysis treatment. Most of the skin disorders described were xerosis, pruritus and hyperpigmentation. The major complication related to the skin alteration was calcifilaxis; being the type of dialysis treatment, the associated diseases and lack of adherence to the prescribed diet, the most influential variables in the appearance of the lesions.

Conclusion

Skin alterations are present in many patients with Advanced Chronic Renal Disease and on dialysis, being xerosis the most frequent alteration, followed by pruritus and hyperpigmentation. The most serious complication related to skin alteration is calcifilaxis, being associated with high levels of serum phosphorus. There are no standardized protocols for the management of skin disorders in these patients.

Keywords : alterations in skin; dialysis; advanced chronic kidney disease; calciphylaxis.

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