Changes in Skin Color in Hemodialysis Patients According to Dialysis Modality

Kim, Chan Ho; Kang, Shin Wook; Moon, Sung Jin; Ko, Kwang Il; Kim, Dong Hyun; Kim, Eun Young; Park, Jung Tak; Chang, Tae Ik; Kim, Hyun Wook; Park, Sun Young; Chang, Jae Hyun; Kim, Dong Ki; Yoo, Tae Hyun; Han, Dae Suk

Abstract

PURPOSE: Skin hyperpigmentation in end stage renal disease patients is known to be attributed to the accumulation of middle molecular weight (MMW) substances such as urochromic pigments and carotenoids. Therefore, there is a possibility that hyperpigmentation may be improved by high-flux hemodialysis (HF-HD) and online hemodiafiltration (HDF). This prospective study was undertaken to investigate the quantitative changes in skin color in HD patients according to dialysis modality.
METHODS
Eighty-two stable ESRD patients undergoing HD were enrolled and divided into three groups according to their dialysis modality. Melanin index and erythema index of forearm and abdomen (nonsun exposed area), and forehead (sun exposed area) were measured by narrow-band reflectance spectrophotometer at baseline and after 12 months.
RESULTS
There were no significant differences in the baseline values of melanin and erythema indices among the three groups. But the changes in forehead melanin index were significantly lower in HDF patients (-1.0+/-2.4%) compared to the LF-HD group (0.3+/-1.6%) (p<0.05), and forehead erythema index was significantly decreased in patients treated by HDF (-1.6+/-2.5%) relative to the lowflux hemodialysis group (-0.1+/-2.5%) (p<0.05).
CONCLUSION
The changes in skin color of sun exposed area were reduced by HDF, suggesting that enhanced removal of MMW substances by convective therapy may be of advantage to skin hyperpigmentation in ESRD patients.