Early signs of Kidney Disease on the Skin
Kidney diseases are global health challenges with increasing prevalence in sub-Saharan Africa in which Ghana is no exception. Currently, about 13.3% of Ghanaians experiences this condition which has shown no promise of a downward trend in future. The skin, been the largest organ of the human body, accounting for almost 15% of the total average body weight of an adult does not fail to show early signs of the diseases. The skin performs vital function including physical protection of internal organs against chemical or biological attacks, prevention of excess water loss from the body, and regulation of body temperature.
The human skin and the kidney share functional similarity: they are both excretory organs, helping the body to get rid of excess fluids and salts. Urine produced by the kidney and sweat produced by the skin as excretory products both contain water, urea, sodium and potassium. In a diseased state of the kidney where its function is compromised, these components of urine that should have been removed by the kidneys are performed by the skin and vice versa. These lead to the manifestation of the following signs on the skin as a result of reduction in kidney function as the disease progresses.
Extremely dry skin
One primary substance both the skin and the kidney work with is water. In a disease state of the kidney, it demands more water to work with from other organs of the body. The kidney then takes up water from the skin in most cases leaving the skin dry. The skin may begin to feel tight, cracks easily and in extreme cases like end-stage renal disease; fish-like scales may develop.
In an advanced kidney diseases, intense skin itching may be experienced by the patient. This may range from irritation to life-disrupting itchy skin. The build-up of waste in the blood due to failing kidney reacts with excessive phosphorus production which contributes to the itchy skin. In an advanced kidney disease, high levels of urea are excreted by sweat glands of the skin. Crystallization of excess urea as water evaporates the skin also leaves an itchy skin.
Risk factors for increased incidence of itchy skin in kidney disease include male sex, high levels of uremic nitrogen, calcium, phosphorus, magnesium, aluminum, vitamin A, and histamine. This itching can occur in all parts of the body as well. A specific area such as the back is mostly the affected part of the body. It is prolonged by sweat and heat. Skin lesions may occur as a result of the scratching of the affected body part.
Skin Rash and Blisters
Skin rashes are Small raised bumps on skin. Persistence appearance skin rashes may be due to the kidneys inability to remove waste from the body. Itchy bumps that are dome-shaped may be a result of end-stage renal disease. Dialysis may be required to remedy the situation. In some case, new bumps form as the old ones clears. Small bumps may sometimes join to form rough, raised patches. Blisters can be seen on hands, face and feet. It will open, dry up and crust over leaving a scar at the affected part.
One major manifestation of kidney disease on the skin is the appearance of changes in the color of the skin. When the function of kidneys goes down, toxins that should have been removed by the kidney build-up on the skin. The skin then experience colour changes such as an unhealthy pale color, Gray hue, Yellowish color, Areas of darkened skin, Yellowish, thick skin with bumps, deep lines, Cysts and spots that look like whiteheads.
Mineral deposit under the skin.
The kidneys have a responsibility to balance minerals such as calcium, sodium and phosphorus. In a failing kidney, levels of these mineral may rise and be deposited under the skin. These minerals may end up being deposited under the skin near the joints painlessly. However Painful Half-and-half nails may be developed. A chalky discharge usually occurs when one of these deposits push through the skin.
The appearance of the finger nails, toe nails or both can be affected by a reduced kidney function. The upper part of one or more nails can be affected by white color patches while the lower part can change color from normal to reddish brown. In addition, the nail can develop White bands running across one or more nails. If steps are not taking to restore normal kidney function, the nails further changes colour to become pale.
The kidneys remove excess water and salts from the body. When they are no more able to perform such function, these excess fluids and salts build-up at specific sites under the skin mostly the ankles, Legs, Feet, Hands and Face to cause swellings. These swellings may be seen in one or several areas of the body.
Kidney disease and its accompanying health challenges leave many of its victims in a confused state. While I appreciate that the above signs might be due to allergic reactions, use of some medications, nutritional deficiency, use of certain toiletries or cleaning products or even physiological inefficiency, I highly recommend individuals experiencing these signs to consult a skin or kidney specialist in other to rule out either possibilities.
Richard Anane Appiah
Principal consultant, Live on healthcare ltd.
The views expressed in this article are the author’s own and do not necessarily reflect The Chronicle’s editorial stance