MULTIVARIATE-ANALYSIS OF CUTANEOUS MARKERS OF AGING IN CHRONIC HEMODIALYZED PATIENTS

Background, Although hemodialysis has been associated with lesions of cutaneous aging, no controlled studies have been done in patients with chronic renal failure under periodic hemodialysis. Our purpose was to determine the prevalence of several clinical parameters of cutaneous aging and their relationship with hemodialysis. Methods. One hundred f ourteen patients on chronic hemodialysis were investigated for the pre sence of several cutaneous aging markers in a cross-sectional study, u sing multivariate analysis to minimize the confounding effect of age. Results. Skin cancer was diagnosed in 3 patients (2.6%), actinic kerat oses in 12 (10.5%), senile lentigo in 22 (20%), senile purpura in 15 ( 13%), and Favre-Racouchot disease in 6 (5%). There was no association with skin types or facial wrinkles with any other of the skin-aging fe atures studied. Muitivariate analysis, controlling for age as a confou nding variable, indicated that the degree of facial wrinkles and the d ecrease in stratum corneum hydration (capacitance) correlated signific antly with the length of time on hemodialysis (P = 0.012 and P = 0.012 , respectively). Favre-Racouchot disease (Odds Ratio [OR] = 1.23, P = 0.055, 95% confidence interval [Cl] 0.99-1.52) and actinic keratoses ( OR = 1.15, P = 0.076, Cl 0.98-1.34) became increasingly frequent with the duration of chronic hemodialysis. Conclusions. These data show a h igh prevalence of cutaneous aging lesions in patients on chronic hemod ialysis. Acceleration of cutaneous aging is associated with time on he modialysis.