Dermatological Manifestations in Pediatric Patients with Chronic Kidney Disease.

Abstract

Introduction: Skin changes are common in chronic kidney disease (CKD) yet data on different skin lesions in children are limited.Aim of the study: We aimed to screen dermatological manifestations in our pediatric CKD patients, and their relationships with CKD stage, dialysis modality, clinical and metabolic parameters.Methods: A descriptive cross-sectional study on pediatric CKD patients, who were divided equally into group 1; CKD stage 5 on regular hemodialysis [online-hemodiafiltration (OL-HDF), high flux conventional hemodialysis (HF-HD), or a hybrid of both], and group 2; CKD stage 2-4 on conservative management.Results: We included 70 pediatric CKD patients, with mean (±SD) age, CKD, and HD durations of 9.23 (±3.9), 3.92 (±2.73), and 2.67 (±1.94) years respectively. Eight (22.9%) patients were on OL-HDF, 7 (20%) on HF-HD, and 20 (57.1%) on a hybrid of both. Xerosis was considered the most frequent skin manifestations (78.6%), followed by pruritus (62.9%), and pallor 35.7%, meanwhile 6 (8.57%) patients had hair and nail abnormalities, where 4 (5.33%) had hair loss, one (1.4%) had albinisms, and one patient (1.4%) had onychomycosis. Skin, hair, and nail abnormalities didn’t differ significantly with CKD stages, HD modalities. Xerosis was associated with lower HD efficacy (Kt/V) and higher white blood cell count, while pruritis was associated with higher hemoglobin level.Conclusion: Skin, nail, and hair abnormalities were not uncommon among our pediatric CKD patients, where xerosis and pruritis were the most common skin manifestations. Kt/V and total white blood cell count had related to xerosis, meanwhile hemoglobin level influenced pruritis.