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Box 1.  

Skin Disorders in Patients With Chronic Kidney Disease

Skin Problems in Chronic Kidney Disease: Conclusions



Skin disorders are a common problem in patients with CKD and can seriously affect the patient's physical and mental health and thus their quality of life. A basic knowledge of the most common dermatological entities encountered in CKD will enable renal physicians to optimize daily patient care and to recognize potentially life-threatening conditions. The clinical management of UP remains a challenge, and a more detailed understanding of its underlying complex mechanisms is required. Further research into the pathological pathways of UP will ultimately provide novel therapeutic strategies with improved efficacy. CUA is a dangerous complication of CKD that requires prompt diagnosis and treatment to alter its devastating course. Emerging new therapeutic options such as the use of bisphosphonates, sodium thiosulfate, calcimimetics and non-calcium-containing phosphate binders seem to have beneficial effects on CUA and hold promise for the future. NSF is now clearly known to be associated with the use of gadolinium-based contrast agents in patients with CKD. The current lack of any efficient therapy for NSF emphasizes the need for intensive campaigns to increase the clinical awareness of this debilitating condition so that it can be prevented whenever possible. Preventive measures, particularly in patients with stages 4 and 5 CKD, include the use of alternative iodine-based contrast agents if possible, or the administration of low volumes of the more stable types of gadolinium-based contrast agent if this type of agent is necessary. In cases of gadolinium exposure, hemodialysis treatment might theoretically offer benefits, but prospective studies that investigate this option are lacking at present.

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