Screening for allergic disorders among adults and children with kidney disease

Abstract

Background: Patients with kidney disease may exhibit various allergic disorders and allergy mimickers. Recognition of these reactions is essential to establish correct diagnosis and initiate the proper treatment. We sought to assess the frequency of different allergic disorders among adults and children with kidney disease Methods: We conducted a cross-sectional study focusing on screening for allergic manifestations among 170 patients (130 adults and 40 pediatric) with different renal diseases. All cases were screened using an allergy questions checklist including allergy type, trigger, duration, associated symptoms, and use of anti-allergic medications. Patients were subjected to laboratory assessment including renal function tests, serum electrolytes, parathormone and complete blood picture. Results: We enrolled 55 patients with acute and 115 patients with chronic renal disease including 41 patients on regular hemodialysis. Thirty-nine percent of patients complained of one or more allergic manifestations, with the bronchial asthma most prevalent (19.4%) followed by allergic rhinitis (7.1%). In the adult group, 40% of patients had allergic diseases; 21.5% had asthma followed by allergic rhinitis (6.9%), while 9.2% had chronic kidney disease-associated pruritus (CKDaP). In the pediatric group, 37.5% had allergic diseases including asthma (12.8%), allergic rhinitis (7.5%), while 10% of patients had CKDaP. Allergic and non-allergic patients were comparable in terms of their clinicodemographic data and laboratory assessment except for higher platelet count among allergic patients (p=0.022). Urea and parathormone hormone (PTH) levels were higher among patients with CKDaP (p-value <0.05). Conclusion: Kidney diseases are associated with a complex array of allergic manifestations. Awareness of allergy disorders and differentiation from allergy mimickers would help in proper direction of the management plan, decreasing comorbidities and improving quality of life.