Complaints related to skin diseases in the diagnosis of many internal organs is useful to physicians. Kidney disease, especially in the skin findings truly is a guide. Chronic renal failure (CRF) in patients with the kidneys from the harmful substances in the skin can not be fully disposed to cause some problems. In addition to drugs used in the treatment of these patients, depending on certain skin complaints are observed.

Skin changes observed with chronic renal failure:
1. Color changes: pale, gray-yellow or brown color changes are very common (about 70%). Depending on the opaqueness revealed anemia. A yellow pigment in the skin due to the accumulation ürokrom gray-yellow color changes can be tracked. Also see the sun a dark pigment in the skin in the regions that increase the formation of melanin under the influence of a hormone-brown discoloration is common.

2. Itching: CRF; itching of the most common cause is related to internal organs. 15% of these patients are 49′unda itching. 50% of dialysis patients entered within 6 months after starting treatment 90′lnda itching occurs. 65% of them are constantly itching. Uremic pruritus usually widespread, severe and is resistant to treatment. Dialysis itself is connected to the attacks are in a state itching, light and can be regional (catheter region, such as the face or legs). Effective dialysis does not correct always itching. CRF and there are many causes of itching in uremia. Dryness, sweat glands to shrink, secondary hyperparathyroidism, increased serum histamine levels, hipervitaminoz A, iron deficiency anemia, neuropathy is a crime. However, after renal transplantation and acute renal failure itching, loss of the chronic failure be seen not been seen, the effect of harmful substances can not be taken as a result suggests. Serum urea and creatinine levels and weak is the relationship between the itch.

Itching is under control in the systematic approach is recommended:

Dialysis should be used in the best way ·. Substances that cause itching, depending on advances, dialysis provides temporary relief.
Which patients should be identified · Ethylene sensitivity. D diet restrictions and phosphate binder therapy use should be encouraged.
· Anemia should be treated (erythropoietin treatment).
If moisturizing and softening the dryness · should be used.
· Antihistamines or ketotifen (2 mg orally, 2 times a day) are available.
Itching persists · UVB (ultraviolet B light) therapy may benefit.
· Resistant cases, oral activated charcoal, kolestiramin, naloksan, meksiletin, such as intravenous lidocaine treatment options are available.
Multi-resistant cases or · UVB + UVB + kolestiramin combination of activated charcoal may be tried.
Topical anesthetics are not available in · Turkey (pramoxine) and topical capsaicin may be useful.

3. Dryness: Chronic renal failure is seen in most patients and is in various degrees. Why had developed fully understood. Of sweat and sebaceous glands as shown in the smaller lot, there are many studies. With the use of moisturizing and softening due to dryness itching may be reduced, but the dryness of the treatment itself is difficult.

4. Of calcification: calcium in patients with chronic renal failure, collagen fibers under the skin around and under the skin accumulates in the skin around additional stiffness makes.

5. Cellular immunity due to breakdown of findings: These findings may occur due to the disease itself. However, especially in transplant recipients (transplant patients) immune system suppressor drug use triggers the formation of infection and cancer. This group developed infections in all recipients during the period of treatment and follow-up can develop independently.

-Bacterial infections: Infections of hair follicles (follikülit, fronkül), fistula, abscesses in the vicinity.
-Viral infections: Herpes simplex (cold sores), herpes zoster (shingles, is lit at night), verrüler (warts).
-Fungus infection: Onychomycosis (nail fungus) and candidiasis (yeast infection fungus), tinea versicolor (Simon)

6. Skin cancer: in particular the risk of developing skin cancer in transplant patients is quite high. Wide variety of skin cancers can exit. In the skin caused puff of red-purple, sun on where and genital areas of red, whole patches in the form of lesions, no, I build on the itching, growth, bleeding, color change and shape irregularities, such as the findings apply to physicians requires.

7. Additional changes in the skin: ‘Nail disorders:’ Half and half nail ‘and called for uremia that this finding is quite specific about half of the quotation in the red and brown discoloration is not left to push.

‘Sweating disorders: Sweat glands shrink due to skin dryness and the amount of sweat produced in high collapse’ uremic frost called ’situation arise.
Hair loss: Disposal of hazardous substances can not influence, anemia and malnutrition due to loss of hair and hair are observed in the mat. Reasons for treatment must be made. When necessary vitamins and iron supplementation may give positive results.

8. Other skin problems:
Contact alleriisi: Nickel (needle), and lots of skin creams, ointments and solutions in the contact area, depending on substances such as redness, itching, and if no visible flakes.

9. Effects due to drugs: Transplant recipients observed in skin problems, suppresses the immune system often are associated with drugs and cortisone treatment. Depending on the use of these drugs, especially the upper layers of the skin changes to be also due to suppression of the immune system and increases the frequency of viral and bacterial infections. Clinical changes similar to steroid side effects and post-transplant in 10 years has seen a high percentage.

Aydede face, facial redness, ‘buffalo hump of the’, skin tear, bruise, skin thinning of the skin dryness, acne, such as findings will be tracked. Vitamin A can be applied to the skin as topical form of retinoic acid reduce the effects of corticosteroids on the skin thinning constructive.
Siklosporine dependent increase in hair growth, hair shedding, growth in the gums, skin color can be observed in the dark.
Can hair loss Azatiopürin and tacrolimus.

WHAT TO DO?
1. Increase in skin dryness and to avoid factors that could irritate the skin:

Very hot and very cold environments not found.
Soon take a bath with warm water.
Less irritating to the skin of the use of soap (Dove, Sebamed, Neutrogena, as Eubos).
Wool and synthetic clothing to prevent any direct contact to the body.

2. Moisturizing and softening to use (bath during and after the bath):
Produced for this purpose and may be useful moisturizer that contains lactic acid. Applied to moist skin after bathing especially in light of the prison facilities have moisture.
Used for this purpose are commercially available and some products are:
Excipial hydro-2% emulsion
-Excipiallipo 2% emulsion
-Nutraplus 10% lotion
Lipo-Ürederm 10% emulsion
10% hydro-Ürederm emulsion-Ürederm 20% cream
-Salmandol medical oil bath
*** Drugs should be used under the supervision of physicians.

3. Sun protection: Suitable protective clothing and sun cream should be used.

4. Frequent self-examination: Skin infections may develop allergic reactions and cancer, early diagnosis is important. Therefore, a problem is discovered should be reported to physicians.