A regular KidneyBuzz.com viewer wrote, "I am currently conducting Dialysis. While the treatments are hard enough alone, sometimes after treatments, I am finding my skin  seems to break out in an itchy hive-like rash. I was wondering if this happens to anyone else, and if so what can I do about it? Thanks."

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Chronic Kidney Disease patients who conduct Dialysis Treatments often notice visible changes to their body such as hair loss, skin irritation, itching, dryness, and rashes. A skin rash is an area of skin that has become swollen or irritated. The most common symptoms of body rash include: Itching, small bumps on the skin, burning, stinging, inflammation, dryness, scaling, blistering, pus-filled lesions, pinkish rings on the skin, and fever. A rash is generally a minor problem that may go away with proper treatment. However, in some cases, a rash does not go away or the skin may become so irritated that medical care is needed. The following are a few tips to avoid skin rashes and other skin complications in order to help improve the overall quality of life for Chronic Kidney Disease and Dialysis patients.

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A study published in the Oxford Journal noted, "Skin rashes are common in patients with Chronic Kidney Disease." One report stated that a Dialysis patient had "soiled most of his clothing and bed sheets with blood from his vigorous scratching." There are three main causes of skin rashes for Chronic Kidney Disease patients:

1. High phosphorus levels - When the kidney function is severely damaged, the excess phosphorus cannot be removed as effectively from the body which causes high phosphorus levels. In turn, patients may experience severe skin itching, skin reddening (make or become red), and even rashes. Hence, be sure to take your phosphorus binders as recommended by your Healthcare Team.

2. Uremic toxins accumulation (toxin build-up) - As Dialysis patients know all too well, when the kidneys stop functioning they also stop filtering waste and toxins out of the blood. While Dialysis attempts to compensate for the kidneys, any sort of interruption to a patient's regular treatment schedule (shortened treatments, skipped treatments, Dialysis access complications, etc.) may result in the accumulation of additional toxins (uremic toxins) in the body and cause a skin rash or itching. Although some things are out of your control, try your very best to not skip or shorten your treatment times. If you are having consistently poor cleanings and toxin build up, then it may indicate a problem that you should bring to the attention of your Nephrologist.

3. Infection - Causes for body rash may also include viral infections such as measles, rubella, chickenpox, shingles, and warts. Bacterial infections such as impetigo can also result in body rash. Methicillin Resistant Staphylococcus Aureus (MRSA) is a very common and highly contagious skin "staph" infection in the Chronic Kidney Disease Community. It's tougher to treat than most strains of Staphylococcus Aureus -- or staph -- because it's resistant to some commonly used antibiotics. MRSA causes infections in different parts of the body and the symptoms of MRSA depend on where you are infected, but can appear as a rash. Chronic Kidney Disease patients are at a higher risk of these types of infections (both viral and bacteria) due to a weakened immune system. Try to avoid infections by washing your hands frequently and implementing some of the infection avoidance strategies offered by KidneyBuzz.com (click here).

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It is important for patients to realize that a body rash could have a variety of causes and solutions beyond the three outlined above such as:

1. Perfumed Soap: Many Chronic Kidney Disease and Dialysis patients constantly use soaps to keep themselves as clean and germ-free as possible. Yet, harsh soaps and detergents are often irritating to the skin, and if you’re particularly sensitive you can end up with a nasty bout of eczema (inflammation of the skin) or hives. If you think that this may be an issue in your case, then consider swapping your current soap for one that is more neutral and less perfumed.
 
2. Skipping A Post-Workout Shower: According to the Huffington Post, the only reason to shower after a workout (light or intense) is not just to avoid smelling. Dr. Holly L. Phillips said, “It’s not the smell of sweat that you have to worry about, but the fact that perspiration left behind on your skin allows bacteria to proliferate, and that can lead to rashes and breakouts.”

3. Stress: Some forms of skin irritations (i.e. Dermatitis) are a result of internal conditions such as anxiety—when the stress turns up the heat; the chemical process in the body react and trigger the skin condition. If you are feeling extremely stressed out then try to meditate, breathe, and decompress the best that your can. Click here for additional tips to help reduce stress and anxiety.

4. Fragrant Body Lotions: Often skin creams and lotions contain harsh chemicals and colors to maintain a “pleasing” smell. The problem is that these additives will almost inevitably irritate sensitive skin. Avoiding them if possible can reduce skin issues. Still, do not stop using prescribed ointments without the explicit direction of your Healthcare Team.

5. Allergies: Seasonal allergies—such as asthma—can trigger an annoying skin reaction, like hives, that form as itchy bumps on the surface of the skin and disappear once the allergen is gone. During the allergy season, attempt to avoid going outside unnecessarily. Close up your windows when possible to prevent allergens from blowing into your house and causing further complications. 

6. Sunscreen: Many Chronic Kidney Disease and Dialysis patients are encouraged to wear sunscreen. However, if a patient's skin is sun sensitive then he/she might be out of luck with sunscreens containing a chemical called Para-Aminobenzoic Acid (PABA). When the product is absorbed by the skin, it could cause an annoying allergic reaction or skin rash. Instead, consider seeking out sunscreens without PABA after discussing the issue with the Healthcare Team.

7.  Heat Rash: As things warm up, in hot muggy weather a heat rash often develops in blisters or red lumps on the skin resulting from excessive sweating and friction (usually from skin or clothing) because sweat ducts are blocked and sweat gets trapped under the skin. The rash will typically clear up in a few hours once you cool down.

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If the issues persist after attempting the relevant strategies above, then ask your Nephrologist for further relief and suggested solutions. How do you manage skin irritations and rashes? Share your response with the over 39,000 KidneyBuzz.com Facebook Fan Page Friends (click here). Also, follow the over 115,000 monthly viewers and visit KidneyBuzz.com every day for the latest breaking news and information which teaches those with Chronic Kidney Disease, Dialysis, Diabetes and High Blood Pressure how to better manage and improve their lives.

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