慢性肾脏病(CKD)是一种进行性疾病,有多种临床表现;当CKD达到终末期时,由于毒素水平升高或持续的促炎状态,出现至少一种皮肤表现。非特异性表现包括瘙痒,干燥症,色素沉着症,获得性鱼鳞病,紫癜斑,和指甲疾病。一些具体的表现是大疱性皮肤病,获得性穿孔皮肤病(APD),爆发性黄色瘤,访问站点感染,钙化性疾病,和肾源性系统性纤维化(NSF)。所有这些皮肤变化对患者产生负面影响;这些皮肤病的早期识别和诊断将改变其治疗质量。探索患者的皮肤是怀疑某些疾病和毒素水平增加的基础;当尿毒症毒素增加时,就会发生瘙痒,指甲疾病与低白蛋白血症有关。这篇综述为临床医生提供了关于CKD临床表现的信息,包括流行病学,病理生理学,临床表现,诊断,组织病理学,治疗,CKD皮肤病对生活的影响。
Chronic kidney disease (CKD) is a progressive disease and has multiple clinical manifestations; when CKD reaches the end stage, at least one cutaneous manifestation appears due to some increased toxin levels or a constant proinflammatory state. Nonspecific manifestations include pruritus, xerosis, pigmentation disorders, acquired ichthyosis, purpuric spots, and nail disorders. Some specific manifestations are bullous dermatoses, acquired perforating dermatoses (APD), eruptive xanthoma, access site infections, calcifying disorders, and nephrogenic systemic fibrosis (NSF). All these cutaneous changes negatively impact patients; early recognition and diagnosis of these dermatoses will make a difference in their quality of treatment. Exploring a patient\'s skin is fundamental to suspect some diseases and increased toxin levels; pruritus occurs when uremic toxins are raised, and nail disorders are associated with hypoalbuminemia. This review provides the clinician with information on the clinical manifestations that occur in CKD, including epidemiology, pathophysiology, clinical manifestations, diagnosis, histopathology, treatment, and life impact of the dermatoses in CKD.