Eight signs of kidney disease on your skin

A 22-year-old youth from Bengaluru was diagnosed with kidney disease after he complained of severe and unbearable itchy skin. The itching kept him up at night and did not reduce despite applying lotions, and creams and taking medicines like antihistamines. Dry skin and severe itching are common signs of kidney diseases, say experts. 

After visiting a physician, Suraj (name changed) noticed high blood pressure. Dr Sanjeev Kumar Hiremath, chief nephrologist and transplant physician, Sagar hospitals, Bengaluru says, “We checked his creatinine levels which were abnormally high and immediately started dialysis. The itchiness is now under control.”

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Itchy/dry skin during winter is not a kidney disease

Dr Hiremath reassures us that not all dry and itchy skin, especially in the winter, is an indicator of kidney disease. “If the itchy lesions and the itching don’t heal with moisturising creams despite taking all the measures, the person must visit a dermatologist or general physician as they can differentiate between kidney diseases and common skin conditions,” he says. 

He also adds that dermatological conditions are indirect evidence of kidney diseases and hence insufficient. “The recommended way is to diagnose it through serum creatinine and urinary protein test,” he says.

Signs of a kidney disease

People observe these signs in the later stages, not in the earlier stages, says Dr Hiremath. 

• Itchy skin

Dr Hiremath says, “About 60-70 per cent of people with kidney diseases will have lesions on their skin. Majority of them have itching as a common sign; it is known as pruritus.”

The itch can be annoying or highly disruptive, says Dr Puru Dhawan, ayurvedic kidney expert and founder Sai Sanjivani, Haryana. “Some people experience itching in a specific area of their skin or in some cases it may cover a large portion of their body,” he says.

Dr Hiremath adds that the itch often gets worse during the early morning or late at night disrupting sleep.

• Extremely rough/dry skin (xerosis)

Dr Dhawan explains that dryness in the skin can lead to the development of fish-like scales. “In addition, the skin may become uneven, crack easily and feel tight. People with end-stage kidney disease may experience dehydrated skin,” he says.

• Rash

Dr Dhawan says that a rash might appear when kidneys cannot eliminate waste from the body. “The rash looks like little, dome-shaped bumps and is highly irritating. These little bumps might occasionally merge to create rough, elevated patches,” he says.

• Swelling

“Kidneys remove salt and excess fluid from the body. Hence, when they fail, swelling can be seen in one or multiple parts of the body such as the legs, ankles, feet, hands and face,” says Dr Dhawan. He further adds that this leads to infections such as cellulitis (bacterial skin infection).

• Blisters

Blisters can appear on hands, face and feet at the last stage of kidney disease, says Dr Dhawan. “The blisters will break open, scab over and dry off. Scars develop as they disappear,” he adds. 

• Calcium deposits

Dr Hiremath says that some people have calcium deposits on the skin and nails causing pain. “The calcium accumulates in small blood vessels causing painful lesions in people with kidney diseases especially those on dialysis,” he says.

• Pigment disorders

Dr Dhawan says that around 25-70 per cent of people with kidney issues encounter skin pigmentation ranging from hyperpigmentation to changes in pallor and yellow discoloration. “The longer a person has kidney problems, the higher the risk of getting a skin pigmentation issue, often seen in the lower limbs,” he says. 

• Nail discolouration

Dr Hiremath talks about a condition called Lindsay’s nail. “The nail will be half white and half pink. However, it is very difficult to identify this condition.”