How to Identify & Treat an Itchy Kidney Disease Rash

The kidneys filter blood by removing waste and excess water. They keep a delicate balance of minerals in the body while also releasing hormones and managing blood pressure.

With chronic kidney disease (CKD), kidney function declines. The main causes of CKD are diabetes and high blood pressure. Other causes include infections, polycystic kidney disease, and lupus.

People with kidney disease can develop skin rashes. These rashes are due to the kidneys' decreased function. The accumulation of waste products in the blood cause skin changes and rashes.

This article will discuss ways kidney disease affects the skin and how to treat skin rash.

What Do Kidney Disease Rashes Look Like?

Acquired perforating dermatosis is a kidney disease rash seen in 2% to 11% of people after they begin dialysis. Dialysis is a procedure to mechanically remove waste from the blood caused by decreased kidney function.

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How the rash develops is not quite understood by researchers. It is thought to start after someone with kidney disease scratches their skin. This causes skin irritation. The irritation leads to swelling from the accumulation of waste products in the body which causes a rash.

The rash is itchy, with firm, dome-shaped skin growths. A healthcare provider can make a diagnosis based on the appearance of the rash, the person's health history, and, if necessary, a skin biopsy, removing a sample of skin for analysis in a lab.

Another type of kidney disease rash is caused by calcium salts collecting in the skin. The rash creates hard, white bumps, which are usually found on the fingertips and around the joints. White fluid can seep from these bumps.

Fluid-filled blisters and the thickening and darkening of the skin can also occur in people with kidney disease.

Other Ways Kidney Disease Affects the Skin

Kidney disease can cause some seriously itchy skin called uremic pruritus. "Uremic" refers to a high level of waste products in the blood from poor kidney function. "Pruritus" is another term for itching. So, uremic pruritus is itching caused by increased waste products in the blood.

Uremic pruritus does not cause a rash, but the skin can become red and irritated from the constant scratching. The itching can be all over the body or in some people it is more focused on their back, face, and arm.

People with kidney disease can also have dry skin and swelling.

Dry skin is seen in 50% to 80% of people who undergo dialysis to treat kidney disease. The dryness typically appears on the arms and legs.

A 2013 study reported that dry skin was caused by the decrease in sweat gland size and the shrinking of sebaceous glands (where oil is made in the skin). It also suggested that diuretics (medications used to increase urine output) may have a factor in the development of dry skin.

When the kidneys aren't working right, they don't pull fluid and salt out of the body. Swelling, also called edema, occurs from the buildup of fluid in the body. The swelling can happen anywhere but is more common in the feet, legs, and hands. If it becomes significant, the skin can look shiny and tight.

Kidney Disease Rash Treatment

Treatment for a kidney disease rash will vary based on its type and cause.

Acquired perforated dermatosis does not have many well-studied treatments. However, a 2014 study reported that some creams and oral medications have been effective. As have phototherapy and cryotherapy with liquid nitrogen.

Treating the white bumps caused by calcium deposits is done by reducing the intake of phosphorus. Foods high in phosphorus are dairy products, fish, chicken, lentils, cashews, and potatoes. When phosphate blood levels go back to normal, the bumps usually go away on their own.

Uremic pruritus has several treatment options available. They include:

• Skin creams, such as Protopic (tacrolimus), capsaicin, and menthol creams
• Oral medication, such as Neurontin (gabapentin)
• Phototherapy
• Acupuncture

Risk Factors of Kidney Disease

Kidney disease is a serious condition that can have severe consequences for the whole body. When the kidneys are not working right then the other organs in the body suffer as well, which can lead to death. According to the Centers for Disease Control and Prevention, it is one of the leading causes of death in the United States.

The risk factors of kidney disease are:

• High blood pressure
• Diabetes
• Heart disease
• Family history of kidney disease
• Obesity

When to See a Healthcare Provider

The CDC estimates that about 37 million people living in the United States have undiagnosed CKD. Therefore, anyone that suspects they have a kidney disease rash and has not been diagnosed with kidney disease needs to see a healthcare provider.

The healthcare provider will evaluate the rash and overall health and then decide if additional testing is necessary to diagnose kidney disease.

Anyone who has been diagnosed with kidney disease and has a new rash should contact their healthcare provider. It's also time to contact a provider if an existing rash is spreading, appears infected, or worsens.

Summary

Kidney disease is a condition that can affect the whole body. When the kidneys are unable to filter the blood, there is a buildup of waste products in the blood, which can cause itchy skin rashes.

These rashes have raised red areas, white bumps, or cause itching with no visible rash.

There are several treatment options for kidney disease rashes, most of which need a prescription.

A Word From Verywell

If you have a rash that you suspect is from undiagnosed kidney disease you need to contact your healthcare provider. Kidney disease is a commonly undiagnosed condition can be successfully treated with the right lifestyle changes and medication .

Anyone with kidney disease should be aware of new rashes. Sometimes they are unavoidable but can be treated. Your kidney specialist (nephrologist) can help diagnose certain rashes and offer treatment options that only a healthcare provider can prescribe.