Dermatological manifestations in children with chronic kidney disease: a study from a North Indian tertiary care institute.

BACKGROUND

Dermatological manifestations due to impaired renal function in children with chronic kidney disease (CKD) are diverse and are an important cause of morbidity.

AIM: To determine the prevalence of dermatological manifestations in predialysis children with different stages of CKD and its association with various metabolic parameters.

METHODS

This cross-sectional observational study was conducted in 200 predialysis children with CKD stages 1-5 and 200 age- and sex-matched healthy controls (HCs). Detailed dermatological examination was performed to check for any pathological/physiological changes in the skin, mucosa, hair and nails, and changes were recorded in a predesigned proforma.

RESULTS

The median age of cases and HCs was 60.50 months (76.5% males) and 62 months (78.5% males) respectively. Skin manifestations were seen in 189 (94.5%) cases and 156 (78%) HCs (P < 0.001). The most common skin manifestation among cases was pallor (75.5%, P < 0.001) followed by xerosis (48.5%, P < 0.001), atopic diathesis (41.5%) and pruritus (13%, P < 0.001), while among HCs, the most common skin manifestation was atopic diathesis (46%), followed by pallor (24%) and xerosis (14%). Xerosis was found to be significantly associated with higher serum creatinine levels (P = 0.04) and hypocalcaemia (P = 0.03). There was no significant association found between pruritus and serum creatinine.

CONCLUSION

Xerosis was significantly associated with higher levels of creatinine and hypocalcaemia. Timely recognition of these symptoms and proper management can improve the quality of life in children with CKD.