Services on Demand
Revista da Associação Médica Brasileira
Print version ISSN 0104-4230
On-line version ISSN 1806-9282
CHOI, Humberto Kukhyun; THOME, Fernando Saldanha; ORLANDINI, Tobias and BARROS, Elvino. Increased skin pigmentation in patients with chronic renal failure undergoing hemodialysis infected with the hepatitis C virus. Rev. Assoc. Med. Bras. [online]. 2003, vol.49, n.1, pp.24-28. ISSN 0104-4230. http://dx.doi.org/10.1590/S0104-42302003000100029.
BACKGROUND: Skin pigmentation is commonly found in patients with chronic renal failure (CRF). This symptom is also one of the most evident features of Porphyria Cutanea Tarda (PCT). Hepatitis C virus (HCV) is an important precipitating agent of this disease, which has been described in patients undergoing hemodialysis (HD). In this paper, we intend to evaluate the prevalence of difuse skin hyperpigmentation in patients with CRF infected with the HCV. METHODS: We developed a transversal study with 47 patients (mean age 50,35 + 15,16 years; 31 men and 16 women) who were on hemodialysis in march of 2001 at the Unit of Dialysis of Hospital de Clínicas de Porto Alegre. Patients were divided in two groups: group 1, anti-HCV positives (n=17), and group 2, anti-HCV negatives (n=30). RESULTS: The prevalence of skin hyperpigmentation related to HD was 36,2% (n=17). There were 10 patients (58,8%) in group 1 and 7 (23,3%) in group 2 (Odds Ratio of 2,52 and 95% Confidence Interval of 1,18-5,4; p<0,05). Among patients who have undergone HD for until 36 months (n=24), 6 were anti-HCV positive and 3 of tham (50%) mentioned skin pigmentation (OR of 9,0 and 95%CI of 1,1-71,0; p<0,05). Patients from group 2 who referenced the symptom have been on HD for a longer period than those who did not (63,85 + 11,9 vs. 29,3 + 4,71 months; p<0,05). CONCLUSIONS: HCV infection was associated with increased skin hyperpigmentation in patients with CRF undergoing HD. Time on treatment was also associated with this signal.
Keywords : Chronic renal failure; Hemodialysis; Skin pigmentation; Hepatitis C virus; Porphyrins.