Disorders of the skin are an important cause of pruritus in CKD. Among patients with kidney disease, dry skin, which can be localized or diffuse, is a common problem. With excessive dryness of the skin, factors such as secretory gland atrophy and reduced water content in the stratum corneum have been reported.[16,17] The effect of uremic toxin deposition on keratinocytes has also been implicated as a cause of pruritus.
Microangiopathy of cutaneous capillaries is another potential mechanism of CKD-ap. Schricker and Kimmel described how disease of the small vessels leads to ischemia and oxidative stress, resulting in capillary injury and fibrosis.
It is important to recognize that certain common skin diseases can be important causes if itch. Psoriasis, eczema, and other skin disorders can affect anyone, including patients with kidney disease. In such cases there are recognizable cutaneous features and response to appropriate treatment.
Curr Opin Nephrol Hypertens. 2022;31(5):435-441. © 2022 Lippincott Williams & Wilkins