Cutaneous manifestations in patients with chronic kidney disease of unknown aetiology treated at the General Hospital, Polonnaruwa

Chronic kidney disease of unknown aetiology (CKD-U) is a significant medical problem affecting the residents of the North Central Province. Cutaneous manifestations are seen in 50-100% of patients with chronic kidney disease. We have conducted a study to describe the prevalence of cutaneous manifestations in patients with chronic kidney disease of unknown aetiology presenting to the General Hospital, Polonnaruwa.

63 consecutive patients with a diagnosis of chronic kidney disease (based on biochemical and or radiological evidence) without any underlying aetiology were enrolled in the study. All patients were examined for the presence of cutaneous manifestations attributable to kidney disease. An interviewer administered questionnaire was used.

The average age of the study population was 60.16 years with a male preponderance (78%). The average duration of CKD-U was 3.92 years. The majority (77%) comprised of farmers and the average duration of residence within the district was 43.42 years. Well water was the major source of water and 85.71% gave a history of use of pesticides in farming.

All participants except one (98.38%) had at least one skin manifestation. The commonest manifestations were xerosis (64.51%), pruritus (35.48%), hyperpigmentation (27.41%), glossitis (25.81%) and palmar pigmentation (22.58%). There were no specific cutaneous manifestations attributable to arsenic or other heavy metal poisoning but callosities of the palms and soles were seen in 29.03% of the participants.

Cutaneous manifestations commonly occur in patients with CKD-U and need to be addressed in their management.