Can kidney disease cause skin rashes?

Can kidney disease cause skin rashes?

Yes. Chronic kidney disease (CKD) is linked to several skin rashes and conditions.

Typical look of a itchy rash linked to advanced CKD (see below)

Here are 10 rashes or conditions linked to kidney disease.

1. Dry skin

Skin can become so dry that it:

• Becomes rough and scaly
• Feels tight and cracks easily
• Develops fish-like scales.

Extremely dry skin is common in people who have end-stage kidney failure (ESRF), which requires dialysis or a kidney transplant.

2. Itchy skin

Extremely itchy skin is a common symptom of advanced chronic kidney disease (CKD). 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.

There are often 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).

If nothing seems to relieve the itch, you should ask to see a dermatologist. Some people who have end-stage kidney failure (ERSF) get relief from a treatment called UVB phototherapy.

3. Swelling

Your kidneys remove extra water 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:

• Legs
• Feet and ankles
• Hands
• Face.

You may see the swelling in one or more areas of your body.

4. Specific rashes (of underlying cause of CKD)

There may be a rash that is a sign of the underlying cause of CKD.

A rash of Henoch-Schonlein Purpura, that can be linked to IgA Nephropathy. It usually appears on the legs, bottom, tummy, chest or back.

5. Blistering rash

Some people who have end-stage kidney failure develop blisters, which can form on their:

• Hands
• Face
• Feet.

Blistering rashes can be a sign of swelling (see 3) or a side effect of high dose furosemide or bumetanide diuretics (water tablets).

The blisters may open, dry up, and crust over. As they clear, scars appear.

6. Gadolinium-induced skin condition

This is an extremely rare side effect that can occur when you have an MRI that requires a contrast agent (like a dye).

Older versions of contrast agents that contain gadolinium increased the risk of a rare but serious disease called nephrogenic systemic fibrosis (NSF). This disease triggers thickening of the skin, organs and other tissues. In some cases, it can cause death.

7. Calciphylaxis

This is a rare side effect. Your kidneys have several jobs. One is to balance certain minerals in your blood, such as calcium and phosphate.

When the kidneys cannot maintain a healthy balance, levels of both can rise. Some people develop deposits of calcium in their skin. This is called calciphylaxis. It is difficult to treat.

Calciphylaxis

8. Skin cancers

Patients who have received an organ transplant have a higher risk for developing skin cancers; in some cases up to 65 times the risk, compared with non-transplant patients. In particular, transplant recipients have a significantly increased risk of developing squamous cell carcinomas (SCCs).

SCC is more likely to spread (metastatic SCC) in organ transplant recipients and may lead to the death of the patient. This is unusual in a non-immunosuppressed individual.

Kidney transplant recipients are also at increased risk for other types of skin cancer, particularly melanoma. These may occur on any site on the body. Melanoma can be very difficult to diagnose in organ transplant recipients, leading to a low threshold to excise any unusual or changing lesion.

Melanoma tends to be thicker and more advanced on diagnosis than in non-transplant patients, and these tumours may behave aggressively in kidney transplant recipients.

9. Vascular access-related ‘steal syndrome’

In dialysis patients, vascular access steal syndrome is a syndrome caused by ischaemia (not enough blood flow) resulting from a vascular access device (such as an arteriovenous fistula or synthetic AV graft) that was installed to provide access for the inflow and outflow of blood during haemodialysis.

Steal syndrome in an arterio-venous fistula (AVF)

10. Infections

Bacterial infection. Wound infections, folliculitis, impetigo, cellulitis and erysipelas are more common in immunosuppressed kidney transplant recipients.

Viral infection. Reactivation of latent HSV and varicella zoster virus infections may occur in kidney transplant recipients due to their immunosuppressed state.

Fungal infection. Pityriasis versicolor, onychomycosis, candidiasis have been described in kidney transplant recipients.

Factors such as gender, time since transplantation, immunosuppressive medication, skin type, tropical environment and UV exposure may be associated with cutaneous fungal infection in kidney transplant recipients.

Summary

We have described ‘can kidney disease cause skin rashes’ (yes, or be related to). We hope it has been helpful.

Other resource

This is a good review article: Goel, 2021

Last Reviewed on 15 April 2024