Letter to the Editor
Comment on “Skin Manifestations of Chronic Kidney Disease”
Comentario a «Manifestaciones cutáneas de la enfermedad renal crónica»
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Tercedor, B. López-Hernández, J.M. Ródenas" "autores" => array:3 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Tercedor" "email" => array:1 [ 0 => "tercedordermatologia@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "B." "apellidos" => "López-Hernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "J.M." "apellidos" => "Ródenas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad de Gestión Clínica de Dermatología, Hospital Virgen de las Nieves, Granada, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Distrito Sanitario Granada, Armilla, Granada, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Gestión Clínica de Dermatología, Hospital Morales Meseguer, Murcia, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comentario a «Manifestaciones cutáneas de la enfermedad renal crónica»" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the recent review entitled “Skin Manifestations of Chronic Kidney Disease,”<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> and would like to add some comments based on our own experience and several articles we have published on this topic in <span class="elsevierStyleSmallCaps">Actas Dermo-Sifiliográficas</span>. While we agree that uremic pruritis—the main symptom experienced by patients on hemodialysis for chronic kidney disease (CKD)—is difficult to control, we believe that the care of the xerosis that accompanies such pruritus can often be of great help and that the role of the dermatologist is central to that care.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3</span></a> The effectiveness of erythropoietin cited by Robles-Méndez et al. on the basis of one study<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> has been called into question by other authors<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>; moreover, erythropoietin is prescribed to almost all patients on hemodialysis, and no differences in the incidence or severity of pruritus have been observed between patients who are receiving such treatment and those who are not.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,6</span></a> We agree that the only definitive treatment for this condition is kidney transplantation.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> However, given the difficulty of achieving transplantation—the only curative treatment—for all patients with advanced CKD and uremic pruritus, we must keep looking for other treatments that can improve the quality of life of these patients.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Furthermore, while half and half nails is the onychopathy most characteristic of patients on hemodialysis, we would assert that this condition is not, as stated by Robles-Méndez et al., specific to uremia because in a case control study we observed it in 3% of the controls.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In another study with multivariate analysis, we also observed that long term hemodialysis for CDK accelerated skin aging in that the presence of markers of skin aging increased in relation to the time on hemodialysis, independent of age.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> It has recently been observed that uremia and aging share many pathophysiological characteristics, which could be explored to identify future therapeutic strategies.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Consequently, we believe that it is necessary to combine our efforts and continue investigating potential new remedies to alleviate the cutaneous manifestations of chronic kidney disease.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Tercedor J, López-Hernández B, Ródenas JM. Comentario a «Manifestaciones cutáneas de la enfermedad renal crónica». Actas Dermosifiliogr. 2016;107:364–365.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Skin manifestations of chronic kidney disease [Article in English, Spanish]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.C. Robles-Méndez" 1 => "O. Vázquez-Martínez" 2 => "J. 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Harwood" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "World J Nephrol" "fecha" => "2015" "volumen" => "6" "paginaInicial" => "19" "paginaFinal" => "30" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010700000004/v1_201604280043/S157821901630004X/v1_201604280043/en/main.assets" "Apartado" => array:4 [ "identificador" => "6208" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010700000004/v1_201604280043/S157821901630004X/v1_201604280043/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821901630004X?idApp=UINPBA000044" ]
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| 2023 Marzo | 38 | 23 | 61 |
| 2023 Febrero | 33 | 20 | 53 |
| 2023 Enero | 27 | 42 | 69 |
| 2022 Diciembre | 53 | 34 | 87 |
| 2022 Noviembre | 31 | 21 | 52 |
| 2022 Octubre | 26 | 18 | 44 |
| 2022 Septiembre | 16 | 38 | 54 |
| 2022 Agosto | 21 | 27 | 48 |
| 2022 Julio | 17 | 29 | 46 |
| 2022 Junio | 12 | 18 | 30 |
| 2022 Mayo | 25 | 32 | 57 |
| 2022 Abril | 26 | 14 | 40 |
| 2022 Marzo | 30 | 39 | 69 |
| 2022 Febrero | 24 | 25 | 49 |
| 2022 Enero | 21 | 29 | 50 |
| 2021 Diciembre | 13 | 30 | 43 |
| 2021 Noviembre | 32 | 29 | 61 |
| 2021 Octubre | 27 | 52 | 79 |
| 2021 Septiembre | 28 | 42 | 70 |
| 2021 Agosto | 20 | 32 | 52 |
| 2021 Julio | 20 | 24 | 44 |
| 2021 Junio | 19 | 22 | 41 |
| 2021 Mayo | 32 | 34 | 66 |
| 2021 Abril | 46 | 48 | 94 |
| 2021 Marzo | 35 | 17 | 52 |
| 2021 Febrero | 30 | 23 | 53 |
| 2021 Enero | 31 | 12 | 43 |
| 2020 Diciembre | 28 | 9 | 37 |
| 2020 Noviembre | 13 | 18 | 31 |
| 2020 Octubre | 19 | 11 | 30 |
| 2020 Septiembre | 20 | 9 | 29 |
| 2020 Agosto | 16 | 19 | 35 |
| 2020 Julio | 23 | 13 | 36 |
| 2020 Junio | 32 | 31 | 63 |
| 2020 Mayo | 31 | 10 | 41 |
| 2020 Abril | 32 | 20 | 52 |
| 2020 Marzo | 28 | 19 | 47 |
| 2020 Febrero | 2 | 0 | 2 |
| 2020 Enero | 4 | 0 | 4 |
| 2019 Diciembre | 8 | 0 | 8 |
| 2019 Noviembre | 4 | 0 | 4 |
| 2019 Septiembre | 4 | 0 | 4 |
| 2019 Agosto | 4 | 0 | 4 |
| 2019 Julio | 4 | 0 | 4 |
| 2019 Junio | 4 | 0 | 4 |
| 2019 Mayo | 8 | 0 | 8 |
| 2019 Abril | 2 | 1 | 3 |
| 2019 Marzo | 4 | 3 | 7 |
| 2019 Febrero | 4 | 0 | 4 |
| 2019 Enero | 2 | 0 | 2 |
| 2018 Diciembre | 3 | 0 | 3 |
| 2018 Noviembre | 3 | 0 | 3 |
| 2018 Octubre | 5 | 0 | 5 |
| 2018 Septiembre | 2 | 0 | 2 |
| 2018 Febrero | 10 | 5 | 15 |
| 2018 Enero | 21 | 5 | 26 |
| 2017 Diciembre | 27 | 3 | 30 |
| 2017 Noviembre | 16 | 9 | 25 |
| 2017 Octubre | 13 | 6 | 19 |
| 2017 Septiembre | 16 | 5 | 21 |
| 2017 Agosto | 17 | 6 | 23 |
| 2017 Julio | 18 | 7 | 25 |
| 2017 Junio | 30 | 11 | 41 |
| 2017 Mayo | 16 | 4 | 20 |
| 2017 Abril | 14 | 3 | 17 |
| 2017 Marzo | 15 | 7 | 22 |
| 2017 Febrero | 13 | 2 | 15 |
| 2017 Enero | 8 | 9 | 17 |
| 2016 Diciembre | 20 | 13 | 33 |
| 2016 Noviembre | 16 | 14 | 30 |
| 2016 Octubre | 21 | 17 | 38 |
| 2016 Mayo | 0 | 1 | 1 |
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