血液透析中慢性肾功能衰竭患者皮肤病表现的横断面研究

Indira Potthuri, Inamadar C. Arun
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摘要

背景:接受透析的慢性肾功能衰竭患者会出现各种副作用和并发症,皮肤病就是其中之一。皮肤是身体最大、最具活力的器官之一,可以用作一个窗口,因为它很容易观察,并反映包括肾脏在内的多个器官的变化。目的:本研究的目的是描述接受血液透析的慢性肾脏病患者的各种皮肤表现。材料和方法:2019年11月至2021年5月,在一家三级护理中心的皮肤科、性病科和麻风病科进行了一项基于医院的横断面观察性研究。记录人口统计学细节和临床表现。数据记录为数字和百分比。对于分类数据,数据摘要中使用了数字和百分比,并通过Mann-Whitney U检验对数据进行分析,以比较两个数据。结果:共有94名患者被纳入研究。最常见的表现是瘙痒(85.1%),其次是干燥症(84%)。研究中的其他发现主要是非特异性变化,如苍白(59.57%)、弥漫性色素沉着(3.2%)和瘀斑(16%)。观察到的指甲变化(56.38%)为半指甲和半指甲(22.6%)、甲裂(11%)和博氏线(9%)。粘膜变化(36.17%)包括舌尖脱落(12.8%)和巨舌症(8.5%)。其他发现如皮肤感染和瘢痕疙瘩。一名患者出现新的发现,如出血性大疱性心绞痛。6.4%的研究组患者出现了类似Kyrle病的特殊变化,其中50%的患者伴有糖尿病。结论:血液透析患者有一系列的皮肤表现。最常见的包括瘙痒和干燥。及时诊断和早期治疗有助于缓解血液透析引起的许多皮肤表现。
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A cross-sectional study of dermatologic manifestations in patients with chronic renal failure on hemodialysis
Background: Chronic renal failure patients undergoing dialysis suffer from various side effects and complications where skin ailments are one of them. Skin is the largest and one of the most dynamic organs of the body and can be used as a window since it is easily accessible for observation and reflects changes seen in multiple organs including kidneys. Objective: The objective of this study is to describe various cutaneous manifestations in chronic kidney disease patients undergoing hemodialysis. Materials and Methods: A hospital-based, cross-sectional, observational study was conducted in the department of dermatology, venereology, and leprosy at a tertiary care center from November 2019 to May 2021. The demographic details and clinical manifestations were recorded. Data were recorded as numbers and percentages. For categorical data, the number and percentage were used in the data summaries, and data were analyzed by the Mann‒Whitney U test for the comparison of two data. Results: A total of 94 patients were included in the study. The most common manifestation observed was pruritus (85.1%), followed by xerosis (84%). Other findings seen in the study were mainly nonspecific changes such as pallor (59.57%), diffuse hyperpigmentation (3.2%), and ecchymosis (16%). Nail changes (56.38%) observed were half-and-half nails (22.6%), onycholysis (11%), and Beau's lines (9%). Mucosal changes (36.17%) included depapillated tongue (12.8%) and macroglossia (8.5%). Other findings such as skin infections and keloid were also noted. New finding such as angina bullosa hemorrhagica was seen in one patient. Specific change like Kyrle's disease was seen in 6.4% of the study group and 50% of these patients had concomitant diabetes mellitus. Conclusion: Patients on hemodialysis present with an array of cutaneous manifestations. The most common include pruritus and xerosis. Prompt diagnosis and early treatment help alleviate many of the cutaneous manifestations posed due to hemodialysis.
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