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The impact of dialysis modality on skin hyperpigmentation in haemodialysis patients

Authors
 Sung Jin Moon  ;  Dong Ki Kim  ;  Jae Hyun Chang  ;  Chan Ho Kim  ;  Hyun Wook Kim  ;  Sun Young Park  ;  Seung Hyeok Han  ;  Jung Eun Lee  ;  Tae-Hyun Yoo  ;  Dae Suk Han  ;  Shin-Wook Kang 
Citation
 NEPHROLOGY DIALYSIS TRANSPLANTATION, Vol.24(9) : 2803-2809, 2009 
Journal Title
 NEPHROLOGY DIALYSIS TRANSPLANTATION 
ISSN
 0931-0509 
Issue Date
2009
MeSH
Adult ; Aged ; Erythema/etiology ; Female ; Hemodiafiltration ; Humans ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/metabolism ; Kidney Failure, Chronic/pathology ; Kidney Failure, Chronic/therapy ; Male ; Melanins/metabolism ; Middle Aged ; Pigmentation Disorders/etiology ; Pigmentation Disorders/metabolism ; Pigmentation Disorders/pathology ; Renal Dialysis/methods* ; Skin Pigmentation* ; Sunlight/adverse effects ; Toxins, Biological/metabolism ; beta 2-Microglobulin/metabolism
Keywords
[beta]2-microglobulin ; haemodiafiltration ; hyperpigmentation ; low-flux haemodialysis ; spectrophotometer
Abstract
BACKGROUND: Skin hyperpigmentation in end-stage renal disease (ESRD) patients has been attributed to the accumulation of middle-molecular-weight (MMW) substances. Although an MMW mechanism suggests that hyperpigmentation may be improved by high-flux haemodialysis (HF-HD) and haemodiafiltration (HDF), this possibility has not been explored. In the present study, we investigated the impact of different dialysis modalities on skin colour in HD patients. METHODS: Eighty-two ESRD patients on HD were divided into low-flux HD (LF-HD), HF-HD and HDF groups. The melanin index (MI) and erythema index (EI) of the abdomen and the flexor side of the forearm (non-sun-exposed areas) and the forehead (sun-exposed area) were determined by using a narrow-band reflectance spectrophotometer at baseline and after 12 months. RESULTS: Even though absolute values of baseline and follow-up MI and EI of the three sites were comparable among the three groups, forehead MI and EI were significantly decreased after 12 months in the HDF group (P < 0.05). In addition, the change in forehead MI was significantly greater in the HDF than in the LF-HD group (-1.0 +/- 2.4% versus 0.3 +/- 1.6%, P < 0.05). Moreover, beta(2)-microglobulin reduction rates were negatively correlated with both changes in forehead MI (P < 0.01) and EI (P < 0.05). CONCLUSIONS: Skin colour of sun-exposed areas was signi- ficantly decreased in ESRD patients receiving HDF therapy, suggesting that enhanced removal of MMW substances by convection may prevent or reduce hyperpigmentation in HD patients.
Files in This Item:
T200903094.pdf Download
DOI
10.1093/ndt/gfp143
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Moon, Sung Jin(문성진)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Jung Eun(이정은) ORCID logo https://orcid.org/0000-0003-0917-2872
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104667
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