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Frequently Asked Questions About Sweating Leading To Skin Complications In CKD & Dialysis Patients

A KidneyBuzz.com viewer asked, "Is the sweat of Dialysis patients different from that of Non-Dialysis patients? It seems like my skin is constantly sticky, clammy and at times my sweat has an unfamiliar smell no matter how many showers I take. Any thoughts?"

The skin of a Chronic Kidney Disease and Dialysis patient is characterized by a multitude of different aspects. Often severe itching of the skin (Pruritus), abnormally dry skin (Xerosis Cutis), darkening of the skin (Hyperpigmentations), and degeneration of elastic tissue (Actinic Elastosis) occur. These symptoms tend to alter and are aggravated relatively quickly when Chronic Kidney Failure patients must conduct regular Dialysis treatments. The following are possible causes and solutions to common issues associated with sweating in Dialysis patients:

SWEATING: Patients conducting Dialysis often note excessive sweating as a result of treatments which can make patients feel uncomfortable and annoyed. Excessive sweating may be caused by Low Blood Sugar (Hypoglycemia) which is often a result of Dialysis even among patients who do not have Diabetes. Consider reducing the amount of fluid removal during treatments as well as working with your Dietitian to appropriately adjust your diet to avoid Hypoglycemia during or after treatments.

Low Blood Pressure (Hypotension) and Electrolyte Disorders are also common causes of excessive sweating. Limiting fluid removal during Dialysis Treatments may similarly reduce severe sweating from these complications. 

AMMONIA SWEAT SMELL: Hyperammonemia is a condition characterized by elevated levels of ammonia in the blood. Increased levels of ammonia in the blood can affect brain tissue, leading to symptoms such as confusion and delirium (rapid change in cognitive function). In some cases, an elevated blood ammonia level will resolve on its own without treatment. Yet, more frequently, high levels of ammonia in the blood and an ammonia sweat smell may be a sign of the need for additional time on Dialysis to improve cleaning. 

STICKY SKIN: There are several common causes of sticky skin in Chronic Kidney Disease and Dialysis patients that do not necessarily require emergency treatment:

- Panic attacks can produce clamminess and sticky skin.
- Low Blood Pressure (Hypotension) can make your skin feel sticky.
- Low Blood Sugar levels may also make your skin clammy and sticky.
- Hyperthyroidism, which refers to an overactive thyroid, causes clamminess. It is not life threatening unless the condition becomes severe quickly.

Other possible causes of sticky skin may be treatable, but require a diagnosis from your Nephrologists. If you are experiencing sticky skin and you have no explanation for it, see your Nephrologists. 

CLAMMY SKIN: Healthgrades.com wrote, "When the body is in any type of circulatory crisis, adrenaline prompts a decrease in the blood flow to peripheral areas of your body (such as your appendages and skin) in order to redirect more blood to the vital organs. This causes the cool and clammy skin." Clammy skin typically refers to the skin turning cooler than normal and moister, despite cool temperatures. 

Frequent causes of clammy skin include acute allergic reaction, anxiety, Low Blood Sugar, severe pain, heart attack, heat exhaustion, pulmonary embolus (blockage of an artery within the lung due to a blood clot), heavy or internal bleeding, dehydration, or pneumonia or severe infection. If a Chronic Kidney Disease patient's clammy skin is persistent or causes concern, then they should seek prompt medical care.

In general, excessive sweating, ammonia in sweat as well as sticky and clammy skin can be a sign of a life-threatening condition if there is chest pain, a rapid heartbeat, difficulty breathing or shallow breathing, swelling in the mouth, face, or throat, a weak pulse or a rapid pulse, blue fingernails and lips, dizziness, confusion, loss of consciousness associated with the skin symptoms. In this case, patients may consider requesting emergency help.

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