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Nail disorder among patients on maintenance hemodialysis
Malihe Charkhchian, Akram Beheshti, Amir-Abdollah Zangivand, Afsaneh Sedighi
DERMATOLOGICA SINICA 31 (2013) 7-10

Background/Objective
Chronic renal failure can lead to nail disorders. The aim of this study was to investigate nail disorders and laboratory data in patients on constant hemodialysis (HD) in a hospital in Qazvin, Iran.

Methods
A case-controlled study was performed. End stage renal disease patients (n = 149) undergoing regular HD and 147 randomly selected individuals were examined for nail disorder. All participants were examined by two trained students and a single dermatologist. Specific investigations such as nail biopsy, potassium hydroxide mount, and fungal culture were done if necessary. Laboratory data were completed for HD patients. Demographic characteristics, the causes of end stage renal disease, and laboratory data were tested in a multivariate analysis.

Results
In this study, 62 HD patients had at least one nail disorder, with leukonychia being the most common in both groups. Clinical onychomycosis, absent lunula and half and half nail were the other common findings in HD patients. Positive mycological culture was noted in four HD patients and in none of the control individuals. The mean duration of HD was a significant predictor associated with the positive clinical onychomycosis (p < 0.05). Although there was no significant correlation between nail disorders and hypertension or heart failure, multiple logistic regression analysis indicated that gender, age ≥ 65 years, and diabetes mellitus (DM) were associated with nail disorder.

Conclusion
The prevalence of nail disorder in this study was correlated with age, DM, and gender. To decrease the prevalence of nail disorder, attention to duration of HD, age, male sex, and DM is very important.

Keywords: maintenance hemodialysis, nail disorders, onychomycosis

   
   
 
 
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