Kidney disease: 11 ways it can affect your skin
If you have kidney disease, you won’t see early warning signs on your skin. However, as the disease progresses, you may develop one or more of the following:
Extremely dry skin. Skin can become so dry that it:
- Becomes rough and scaly
- Feels tight and cracks easily
- Develops fish-like scales
Itchy skin. Extremely itchy skin is a common symptom of advanced kidney disease. The itch can range from irritating to life-disrupting. Your skin may itch all (or most of) the time.
Some people have itch on one area of their skin. The itch can also spread across most of your body.
Scratch marks and other signs of scratching. When you scratch often, it affects your skin. You can develop:
- Raw, bleeding skin or sores
- Thick, leathery skin (lichen simplex chronicus)
- Firm, very itchy bumps (nodularis prurigo)
Color changes to your skin. When the kidneys stop working as they should, toxins build up in your body. This build-up can cause color changes to the skin. You may see any of the following:
- An unhealthy pale color
- Gray hue
- Yellowish color
- Areas of darkened skin, as shown here
- Yellowish, thick skin with bumps and deep lines
- Cysts and spots that look like whiteheads
Nail changes. Kidney disease can affect the appearance of your fingernails, toenails, or both. People who have advanced kidney disease can develop:
- A white color on the upper part of one or more nails and a normal to reddish brown color below, as shown here (half-and-half nails)
- Pale nails
- White bands running across one or more nails (Muehrcke’s nails)
Swelling. Your kidneys remove extra fluids and salt from your body. When they can no longer do this, the fluids and salt build up in your body. This build-up causes swelling, which you may notice in your:
Rash. When kidneys cannot remove waste from your body, a rash can develop. One rash that occurs in people who have end-stage kidney disease causes small, dome-shaped, and extremely itchy bumps. As these bumps clear, new ones can form. Sometimes, the small bumps join together to form rough, raised patches.
Blisters. Some people who have end-stage kidney disease develop blisters, which can form on their:
- Hands (as shown here)
Lump in your belly. This can be a sign of kidney cancer. In its early stages, kidney cancer seldom causes symptoms. When the cancer advances, it can cause a mass or lump on the:
- Lower back
Skin too tight to pinch. This is an extremely rare side effect that can occur when you get an MRI or another test that requires a contrasting agent. A doctor may request a contrast agent to get a better view inside an area of your body, such as a blood vessel. If you need a contrasting agent, it will be injected into a vein before your test.
Gadolinium is a contrasting agent that can affect your kidneys. When this happens, it can cause:
- Areas of hard, shiny skin that become too tight to pinch
- Inability to fully bend a knee, elbow, or other part of your body
- Skin that feels bound down
Calcium deposit under the skin. Your kidneys have several jobs. One is to balance certain minerals in your blood, such as sodium and phosphate. When the kidneys cannot maintain a healthy balance, levels can rise. Some people develop deposits of calcium in their skin, such as the patient in this picture. This patient also has half-and-half nails, which is another sign of kidney disease.
Calcium deposits usually develop around a joint and are not painful. However, when they occur within a fingertip, they can cause a great deal of pain.
If one of these deposits pushes up through the skin, you may see a chalky discharge.
How to find kidney disease before it affects your skin
The most common form of kidney disease is chronic kidney disease (CKD). It develops when kidneys become permanently damaged. About 37 million people are estimated to have CKD, and most don’t know they have it, according to the Centers for Disease Control (CDC).1
You can find kidney disease in an earlier stage (before permanent damage occurs) by seeing your primary care doctor. Blood and urine tests can tell your doctor how well your kidneys are working.
These tests are extremely important if you have:
High blood pressure
Anyone who is 65 years of age or older should also be screened for kidney disease.
How dermatologists help patients with kidney disease
Kidney doctors, called nephrologists, often care for patients with kidney disease. When a kidney disease affects the skin, a nephrologist may team up with a dermatologist. Some skin conditions that develop due to kidney disease can be difficult to control. For example, if a patient has extremely itchy skin, it may be impossible to sleep through the night. A board-certified dermatologist can help a patient get some relief. This may involve using the right balance of moisturizers and medication that you apply to the skin. Some patients get relief with a treatment called UVB phototherapy.
The right skin care may also help. If the kidney disease is causing extremely dry skin, these tips from dermatologists may help:
Self-care: Dry skin
1 Centers for Disease Control and Prevention. “Chronic kidney disease in the United States, 2019.” Page last reviewed Mar. 11, 2019. Last accessed Feb. 27, 2020.
Image 1: Image used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Images 2, 3, 6, 9, 10: Getty Images
Images 4, 5, 7, 8, 11: Journal of the American Academy of Dermatology
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