Dialysis and dry skin: reflections and remedies

Abstract

Dialysis and dry skin: considerations and remedies Uremic pruritus is the most distressing symptom of renal disease, even in patients adequately dialysed. Dry skin (xerosis) is the most frequent cutaneous manifestation of renal disease and has been suggested as a cause of uraemic pruritus. Despite a plethora of suggested mechanisms, the pathophysiology of uraemic pruritus remains elusive. Although a positive correlation between the severity of clinical dryness and pruritus has been shown, it has been impossible to find a relationship between trans-epidermal water loss, or skin hydration, and pruritus. Recent studies indicate that the reduction in glycerol content influences skin hydration and independently influences the epidermal barrier function. In order to counteract skin dryness it is recommended to correctly clean the body and to use an adequate topical product. A non foaming cleansing cream easy rinsing with mild tensioactive agents is recommended. Then a product able to attract water from inner skin and to retain it inside the stratum corneum, thus restoring its plasticity and smoothness, has to be applied. The application of an ointment with auto-hydrating activity containing a mixture of polymeric long chain vegetable polyglycerols combined with a blend of polyisobutenes provides a quick healing of xerosis.