Cutaneous Manifestations in Patients on Hemodialysis and Assessment of the Changes in Quality of Life After 12 Weeks of Treatment by a Dermatologist.

Abstract

Background: Cutaneous manifestations are frequently observed in end-stage kidney disease (ESKD) and affect the quality of life (QoL) of patients undergoing maintenance hemodialysis (HD). Even patients undergoing HD who frequently visit hospitals do not receive active dermatological care. The aims of this study were to assess the cutaneous manifestations of patients undergoing HD and investigate changes in their QoL before and after active treatment by dermatologists.

Methods: A 12-week prospective study was conducted in two HD centers. Patients in one center received dermatological intervention, while patients in the other center received conservative management by a nephrologist. Patients scored their QoL using the Dermatology Life Quality Index (DLQI) and the Skindex-29 at the start of the study and 12 weeks later. Two matched groups were formed using propensity score matching. Simple and multiple linear regression analyses were used to identify associations between dermatological treatment and the improvement in QoL.

Results: In total, 120 patients were included, of whom 65 and 55 were in the intervention and control groups, respectively. Approximately 93.8% of the patients had dermatological manifestations, with pallor and xerosis being the most common. Improvement in QoL, as assessed using the DLQI, was confirmed after 12 weeks in the overall population. However, active intervention by a dermatologist did not significantly improve QoL.

Conclusion: Patients treated with dermatological intervention by a dermatologist did not achieve greater improvements in QoL than control patients. Therefore, careful assessment of skin issues in patients with ESKD should be undertaken by nephrologists, and the best possible treatment should be administered.