Haemodiafiltration effect on skin hyperpigmentation....

The quantitative evaluation of online haemodiafiltration effect on skin hyperpigmentation
Nephrology Dialysis Transplantation - Advance Access
published online on August 9, 2010
http://ndt.oxfordjournals.org/cgi/content/abstract/gfq479

Masanori Shibata1, Kojiro Nagai2, Kazumasa Usami3, Hideo
Tawada1 and Shinkichi Taniguchi4

1 Department of Haemodialysis, Koujukai Rehabilitation
Hospital, Aichi, Japan
2 Department of Nephrology, Course of Biological
Medicine, School of Medicine, The University of
Tokushima, Tokushima, Japan
3 Department of Internal Medicine, Taigenkai Hospital,
Aichi,Japan
4 Department of Dermatology, Wakayama Medical University,
Wakayama,Japan

Submitted by Mr CS Shoong

Abstract

Background. Skin pigmentation is a common problem for dialysis patients, but little is known about the factor responsible for the colour intensity. Middle-molecular-weight (MMW) substances have been suggested to be responsible for the skin colour. Several papers have reported that β2-microglobulin (β2-MG) correlates with the skin colour, and haemodiafiltration (HDF) is effective to reduce the skin hyperpigmentation. However, a quantitative skin colour follow-up on patients treated with online haemodiafiltration (online HDF) has not been performed.

Methods. Sixty-one patients were enrolled in this study. Quantification of skin colour was done using a reflected light colorimeter. Among them, 51 patients were under haemodialysis (HD), and the other 10 patients were under online HDF. Follow-ups to estimate the skin colour change were performed for 6 months. Among 10 patients under online HDF, four patients were also investigated by crossover way between HD and online HDF.

Results. Compared with controls, patients treated with HD had darker skin. The colour value was well correlated with age, haematocrit, sex, diabetes and β2-MG but not with Kt/V. The skin colour got worse under HD treatment as well as the values of β2-MG, but online HDF improved the hyperpigmentation and the β2-MG values.

Conclusions. Our data show the effectiveness of online HDF on skin colour and suggest that HD patients’ skin colour can be improved by modality change.