The quantitative evaluation of online haemodiafiltration effect on skin hyperpigmentation

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2011-03, Vol.26 (3), p.988-992
• Main Authors: SHIBATA, Masanori, NAGAI, Kojiro, USAMI, Kazumasa, TAWADA, Hideo, TANIGUCHI, Shinkichi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; beta 2-Microglobulin - metabolism; Biological and medical sciences; Case-Control Studies; Cohort Studies; Cross-Over Studies; Emergency and intensive care: renal failure. Dialysis management; Evaluation Studies as Topic; Female; Follow-Up Studies; Glomerular Filtration Rate; Hemodiafiltration - adverse effects; Humans; Hyperpigmentation - diagnosis; Hyperpigmentation - etiology; Hyperpigmentation - metabolism; Intensive care medicine; Kidney Failure, Chronic - therapy; Male; Medical sciences; Middle Aged; Online Systems; Pharmacology. Drug treatments; Prognosis; Risk Factors; Skin Pigmentation; Survival Rate; Urinary system; Young Adult
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfq479

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 β(2)-microglobulin (β(2)-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. 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. Compared with controls, patients treated with HD had darker skin. The colour value was well correlated with age, haematocrit, sex, diabetes and β(2)-MG but not with Kt/V. The skin colour got worse under HD treatment as well as the values of β(2)-MG, but online HDF improved the hyperpigmentation and the β(2)-MG values. Our data show the effectiveness of online HDF on skin colour and suggest that HD patients' skin colour can be improved by modality change.