Skin Disorders in Kidney Disease: Core Curriculum 2026.

Skin disorders occur commonly in patients with chronic kidney disease (CKD) and may greatly impact their quality of life. These skin disorders have varying underlying pathophysiologies, but there are a few common mechanisms including the accumulation of uremic solutes, metabolic disturbances, and inflammation. Pruritus in the setting of CKD (CKD-associated pruritus or CKD-aP), acquired perforating disorder (APD), calcinosis cutis, calciphylaxis, cutaneous lupus, and vasculitis are skin disorders often occurring in association with kidney disease and with which clinicians should be familiar. CKD-aP is reported to have a prevalence of 40% among patients receiving dialysis and 20% with earlier stages of CKD. Acquired perforating disorder (APD) is a skin disorder seen commonly in patients with diabetes mellitus and kidney failure that presents typically with crater-shaped nodular eruptions with a central hyperkeratosis. Calcinosis cutis is a skin disorder that occurs when calcium salts deposit into skin and subcutaneous tissues. Calciphylaxis is a rare cutaneous vasculopathy characterized by microvascular calcium deposition and thrombosis leading to tissue ischemia and subsequent skin necrosis. Lupus erythematosus and the vasculitides are systemic disorders with distinct skin manifestations that may offer clues as to the underlying disorder.