Itching and other skin stuff

[Fatkidney]

I'm curious to hear what your experiences have been with itchy skin?  What did it feel like when you started getting it? Were you pre-D?  Is it the toxic buildup? Were you itchier at certain times of the day/night? 

Also, my face is starting to break out, I'm reminding me of my teenage self, not in a good way.  Do you suppose that could be from the toxic buildup? anybody else get acne once kidney function got low? 

[Sydnee]

Ed and I were talking about this the other day.
We both have spots that itch. We both started pre-D. I am still pre-D.
My mother had spots on her hands and face that she scratched so much that she developed sores. She never started dialysis but had PKD. My aunt Betty got these same spots that developed into the sore after she started dialysis. She thought the sore were from PKD.
I have started getting these a small one on my face. It first looked some what like a pimple at first.  But it itches a lot.

[Mr Pink]

I've had some issues with itchy skin. I've had a history of having oily skin, although over the years my skin has held up ok. A few months ago, I started to itch in various places, which was indicative to me being close to requiring dialysis. As my renal function fell below 12%, the itching inceased, and was noticable usually right after dinner time, mostly on my back. Having now started dialysis, the itching seems to have stopped, although it's still early days. For relief, I would stand under a hot shower, and subsequantly was showering twice a day.   

[Wat76]

Might be too much phosphorus in the diet. Check what you are eating. It happened to me before I learned my food choices.

[Grumpy-1]

I've had bouts with itchy skin.  All over but mostly legs, arms and back.  It seems that when my phosphorus level were high, I would Itch more.  Now that the levels are down less itchiness.  Grumpy

[Mr. B 123]

I had itching issues, when my kidney function was at 10%, still pre-D.  Mostly my legs and arms in the evening, tried lotion but that didn't help.  Went into the hospital for a week and kidneys got back around 20% and the itching went away.  From what I understand when the kidneys are not functioning the phosphorus builds up and the itching begins.

[chinksnicky]

Itching will be worse when your phosphorus is high,but my neph told me that dialysis in general will cause it.You can use hydrocortisone locally or take Benadryl if it's too bad.I get it mostly on my access,legs and back,it comes and goes.

[Willis]

My neph has said the same as others above about high phosphorus causing itchiness. However, she said (and my experience with itchiness seemed to confirm this) calcium AND phosphorus work together in a very bad way. My clinic wants me to keep my Calcium X Phosphorus number (the product of the two numbers) below 55. She explained how the calcium and phosphorus (and thyroid Pth too) interact to create large crystalline molecules (salts) that migrate to the skin and cause the itchiness. She also warned that beyond that, if left untreated, the itchiness may go away...but that is a bad sign and can lead to severe damage to the circulatory system and ultimately gangrene. Not good.

http://jasn.asnjournals.org/content/16/11_suppl_2/S93.full

Why would the adaptive, compensatory mechanisms that protect phosphate and calcium homeostasis have such ultimately devastating consequences for these patients? Tight control of both phosphate and calcium homeostasis is essential to the normal functioning of virtually all life-sustaining, physiologic processes. Cell phosphate is at the core of all energy-dependent physiologic processes. Cell calcium and its ubiquitous binding protein are the triggers that initiate virtually all cellular functions. Thus, compromising the tight regulation of these two ions, even short term, carries an immediate risk to the highly integrated physiologic systems that are critical to sustaining essentially all biologic process. Viewed in that context, a trade-off that maintains biologic systems for years but ultimately leads to life-threatening conditions later in patients with CKD and ESRD is understandable.

Unfortunately for the patient with early CKD, these adaptive mechanisms are so successful that even though GFR is significantly compromised, serum phosphate does not become elevated until the late stages of renal disease, at which time health care providers recognize the need to respond. By that time, parathyroid hyperplasia is irreversible, bone loss is significant, and soft tissue calcification, even if not grossly evident, is already well established.

 

[M3Riddler]

I'm curious to hear what your experiences have been with itchy skin?  What did it feel like when you started getting it? Were you pre-D?  Is it the toxic buildup? Were you itchier at certain times of the day/night? 

Also, my face is starting to break out, I'm reminding me of my teenage self, not in a good way.  Do you suppose that could be from the toxic buildup? anybody else get acne once kidney function got low?

The itching is more than likely too much phosphorus buildup in the sytem. In center dialysis can only remove approx 700-1000mg of phosphorus per treatment.  Normally a person will take in more than this between treatments and then there is the long weekend.  Ultimately, there is a net gain of phosphorus with in center dialysis and it can lead to other problems such as bone issues and amyloidosis.   You also want to watch your PTH levels.