Archives

  • 2018-07
  • 2018-10
  • 2018-11
  • 2019-04
  • 2019-05
  • 2019-06
  • 2019-07
  • 2019-08
  • 2019-09
  • 2019-10
  • 2019-11
  • 2019-12
  • 2020-01
  • 2020-02
  • 2020-03
  • 2020-04
  • 2020-05
  • 2020-06
  • 2020-07
  • 2020-08
  • 2020-09
  • 2020-10
  • 2020-11
  • 2020-12
  • 2021-01
  • 2021-02
  • 2021-03
  • 2021-04
  • 2021-05
  • 2021-06
  • 2021-07
  • 2021-08
  • 2021-09
  • 2021-10
  • 2021-11
  • 2021-12
  • 2022-01
  • 2022-02
  • 2022-03
  • 2022-04
  • 2022-05
  • 2022-06
  • 2022-07
  • 2022-08
  • 2022-09
  • 2022-10
  • 2022-11
  • 2022-12
  • 2023-01
  • 2023-02
  • 2023-03
  • 2023-04
  • 2023-05
  • 2023-06
  • 2023-08
  • 2023-09
  • 2023-10
  • 2023-11
  • 2023-12
  • 2024-01
  • 2024-02
  • 2024-03
  • 2024-04

    • The collected data were analyzed using

    2018-11-12

    The collected data were analyzed using SPSS software (version 11.0; SPSS Inc, Chicago, IL, USA). The Fisher\'s exact Chi-square test and the Student t test were used to assess statistical relationships between variables. Demographic characteristics, medical data, and laboratory test data were subjected to a multivariate analysis. Continuous data are presented as mean ± standard deviation. A p-value <0.05 was considered significant.
    Results Of 149 HD patients, 96 (64.4%) were male. Mean age was 55.9 ± 16.1 years (range 13–91 years) and the mean dialysis duration was 40.85 ± 42.64 months (range 3–228 months). In the control group, 88 (59.8%) were male and mean age was 55.7 ± 17.9 years (range 8–75 years). The causes of ESRD in the patient cohort are shown in Figure 1. Overall, 62 HD patients and 36 control individuals had at least one nail disorder. There were 96 nail lesions identified in HD patients and 38 in the control group, as some of the patients had more than one nail disorder. The prevalence rates of the different types of nail disorders are shown in (Table 1). Of the 62 HD patients (all HD cases had nail disorders), 47 were male, 24 were age ≥ 65 years, 31 were positive for dacomitinib (DM), 28 were positive for hypertension, and 11 were positive for heart failure. The presence of nail disorders in HD patients was shown to be statistically related to sex, DM, and age (Table 2). Leukonychia was the most common nail change in both patients and controls. Other common findings in HD patients were clinical OM, AL, and HHN followed by splinter hemorrhage, onycholysis, pitting, culture positive OM, thin nail, undiagnosable lesion, subungual hyperkeratosis, koilonychia, cyanosis, pincer nail, melanonychia, and clubbing. In the control group, after leukonychia, AL and onycolysis were the most common nail disorders. Furthermore, the prevalence of clinical diagnosis of OM was established in 11 HD patients and two controls according to the presence of both positive clinical signs (such as discoloration of nails, changes in nail thickness) and positive KOH test. Positive mycological culture was noted in four HD patients in case group and in none of patients in control group (Table 3). None of the patients had a positive familial history or history of nail trauma, tight and high heeled or traumatic shoes, and excessive sweating of foot during activity. The clinical and biochemical characteristics of the HD patients are shown in Table 4. The results of our study showed that the mean duration of HD in patients with positive clinical OM was more than that in those without (p < 0.05). Apart from serum ALP, alanine aminotransferase, aspartate aminotransfrase, and total iron binding capacity (p < 0.05), the other clinical and biochemical parameters had no statistically significant differences in either group.
    Discussion CRF is a known cause for several nail pathologies. Nail abnormalities have been reported in 60% to 76% of patients undergoing HD. In a case-control study, Saray et al reported at least one type of nail pathology in 69.8% of HD patients and 39.2% of a control group. In this study AL, OM, and splinter hemorrhage were the most common disorders. The overall prevalence of nail pathology in this study was not correlated with age, sex, and HD duration, although they showed a possible relationship between HD duration and OM (p = 0.05). In another study Dyachenko et al reported nail disorder in 11.6% of controls, 60.3% of CRF and 62.3% of HD patients. The most common disorders in controls, in CRF patients, and in patients on HD were: OM; AL, OM, and HHN; and HHN, AL, and OM, respectively. Male gender, age above 65 years, DM, hypertension, heart failure, and PTH above 220 μEq/mL were the most important risk factors in this study but duration of HD was not important. Salam et al reported at least one nail disorder in 76% of HD patients and 30% of controls. In this study HHN was the most common finding followed by AL, onycholysis, brittle nail, beau\'s nail, clubbing, longitudinal ridging, OM, and other disorders. They did not find significant correlation between nail pathology and duration of HD.