Dermatological Manifestations In Children With Chronic Kidney Disease: A Study from A North Indian Tertiary Care Institute.

Dermatological manifestations due to impaired renal functions in children with chronic kidney disease (CKD) are diverse and are an important cause of morbidity. We aimed to determine the prevalence of dermatological manifestations in predialysis children with different stages of CKD and its association with various metabolic parameters.This cross sectional observational study was conducted in 200 predialysis children with CKD stage 1-5 and 200 age and sex-matched controls. Detailed dermatological examination was done for any pathological/physiological changes in the skin, mucosa, hair, and nails, and changes were recorded in a pre-designed proforma.The median age of cases and controls 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%) controls (p<0.0001). The most common skin manifestation among cases was pallor (75.5%, p<0.0001) followed by xerosis (48.5%, p<0.0001), atopic diathesis (41.5%), and pruritus (13%, p<0.0001). Among controls, 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-0.044) and hypocalcemia (p-0.032). There was no significant association found between pruritus and serum creatinine.Xerosis was significantly associated with higher levels of creatinine and hypocalcemia. Timely recognition of these symptoms and proper management can improve the quality of life in children with CKD.

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Authors: K Pratyusha, L Dawman, K Vinay, K Tiewsoh, I K Sharawat