Peeling skin?

[pelagia]

My husband is 3 weeks out from a double nephrectomy and is now on dialysis.  The skin over most of his body has already peeled once and now it is even peeling on the palms of his hands.  No amount of cream is stopping the peeling.  The surgeon said something about this being a function of the shock to the body from the surgery or possibly the result of a reaction to the pain meds he was taking after surgery (they were making him itch like crazy...). 

Has anyone else seen this happen after a double nephrectomy or perhaps associated with beginning dialysis?  If you are aware of any website that discusses this reaction, please let me know.

thanks!

[cris]

Pelagia,
For my Mom, this was a natural reaction on the first 4 months of hemodialysis. Check the phosphorus lab results. But with Mom even when the phosphorus are ok, she still itches before. But with constant skin moisturizer, her skin has peeled completely and the itch was gone. Even her head had the scaly itch, for the first time in her 78 yrs., but now it's gone. Maybe, it's the way of the body adapting to the new thing with the dialysis system. But be aware too that the itchiness maybe due to some allergic reactions being used at the dialysis center.
Don't worry the itching will go away.
love,
cris

[pelagia]

Thanks for letting me know about your Mom's experiences Cris!

I found this document concerning pruritus in ESRD on the web and sent it with my husband to dialysis today. 

www.promotingexcellence.org/ files/public/grantee_tools/bmc11.pdf

He has been itchy, which may point to pruritus, but that seems to come and go.  I am getting the impression from poking around on the web that the skin is pretty sensitive to the physiological stresses associated with kidney disease.  Since he's only been on dialysis for a relatively short amount of time, we don't have many numbers to evaluate.  The first set we have is from right after his hospital stay and I don't think they can be very representative since he had barely eaten for a week.  We are waiting on some bloodwork results this week.  I worry that the peeling skin is a sign that things are amiss inside.  I guess we'll have a better idea when he gets his numbers...

[okarol]

Jenna lost about half her hair after beginning dialysis and the nurses said it's the body's response to the stress of dialysis. I think it was more likely the stress of kidney failure and resulting dehydration/malnutrition that comes with the final days before dialysis begins, but that's my opinion.
This is from: http://www.ikidney.com/article.php?id=20070207201058

The Kidney Connection - Skin and Hair Problems

Skin and hair problems affect many people on dialysis. As a dialysis patient, your skin may appear to be more fragile and may tear or bruise more easily than normal. There is also a chance you could experience some unwanted hair growth or loss, but there's a better chance the condition will revert to normal once you have been on dialysis for a while. Getting enough dialysis and having a kidney transplant may also help clear up skin and hair problems.
 
"Battle Scars"
If you have been a chronic dialysis or a kidney transplant patient for some time, you probably have some "battle scars." These could result from surgery to implant your vascular access, peritoneal dialysis catheter, or from a kidney transplant.
 
Bear in mind that such scars are normal. Maybe it would help for you to consider them as symptoms or signs of the battles against kidney disease you have fought and won. And remember that, no matter what your body looks or feels like on the outside, you are the same wonderful you inside.
 
Skin Color and Bruising
While some skin problems can be hardly noticeable, others may be a blow to your body image. When waste products begin building up in your body, there could be changes in your skin color. Your skin may take on a gray/yellowish tinge or it could darken.   
 
Bruising of the skin may occur if you have too high a dose of heparin. It may also happen if the blood level of platelets (a.k.a., clotting cells) is lower than it should be. Too few platelets may cause bleeding gums. Prednisone or blood thinners like coumadin may also increase bruising.
 
An Itching Question
If you are a long-time dialysis patient, the chances are up to 95% that you have had problems with itching skin. If you do, ask your doctor if you have higher levels of phosphorus in your blood. The extra phosphorus can bind with the calcium and cause a buildup of itchy, sharp crystals. You may be able to alleviate this problem by taking your phosphate binders with food.
 
Not getting enough dialysis could be a cause of itching. So could dry skin as well as possible allergies to medications, detergent, the dialyzer, bloodlines, or bags as well as bleach on the dialysis chair. If itching occurs only when you are on dialysis, ask your doctor about a possible allergy. One particular type of heparin may make you itch. If the cause is bleach on your dialysis chair, cover the seat with a towel and/or alert your dialysis staff to the problem.
 
Some over-the-counter (OTC) lotions such as coconut oil may alleviate the itching. Ask your doctor about lotions or an antihistamine that could help.
 
Hair Today, Gone Tomorrow?
"Yes and no," or "not necessarily." Since hair consists of protein, if you become malnourished, as many dialysis patients do, your hair may be prone to break more easily and fall out. Eating enough good protein will help, but it takes about three months before the hair begins to grow back. Ask your renal dietitian about good protein sources.
 
There are even some patients who have reported hair loss when their units changed the type of dialyzer they use. You can also ask your doctor to check your thyroid and protein (albumin) levels. Consult your hair stylist for tips on how to hide thinning hair.
 
Other Hairy Causes
Poor nutrition, zinc deficiency, the side effects from some medications, thyroid problems, and other hormone imbalances can affect your hair. Always check with your doctor for an evaluation and if there are any OTC hair growth medications that are safe for you to take.
 
Blood pressure and transplant medications can also make the hair on your face and body grow more than you may want. Ask your healthcare professional about ways of removing unwanted hair growth, and never stop taking your BP or transplant medications with talking with your doctor first.
 
Other Information
Here are some websites you can log onto for further information:

    * American Association of Kidney Patients, www.aakp.org/aakp-library/Skin-Problems-Kidney-Disorders/.
    * Kidney SchoolTM, www.kidneyschool.org/mod_11.
    * Life Options Rehabilitation Program, www.lifeoptions.org/combined/materials/indexpa.shtml.
    * National Kidney Foundation, www.kidney.org/kidneydisease/ckd/fabryDisease.cfm.
.....................

[Ohio Buckeye]

After my leg amputation I had eeling flaky skin.
I thought it was because it was so dry from being in the hospital.

[boxman55]

same with my foot after the toes where amputated. Skin just peeled in big flakes. They gave me a tube of Aloe Vesta Protective ointment the main ingrediant is petrolatum 43% so almost half the ingrediants is this petro stuff. And it works great. My skin was chunking off and after putting this stuff on, the next morning my foot was smooth, and I mean smooth. It is made by Convatec 1-800-422-8811....Boxman

[kidney4traci]

I use Burt's Bees Baby oil and it works great.  No big peeling though, just VERY dry skin.

[pelagia]

Thanks for the good ideas.  I think we can rule out allergic reactions to the heparin and dialysis chair as the itchiness comes and goes on and off dialysis days.  He has been using vitamin E cream and an oatmeal based lotion.  Sounds like maybe he needs something more protective with a heavier base.