ABSTRACT
The skin is the most visible and easily accessible organ of the body. For an astute clinician, the skin may function as an important diagnostic window to diseases affecting internal organs. This is especially true for the renal system. Chronic renal failure, regardless of its cause, often produces xerosis, pruritus, sallow hyperpigmentation, and nail changes. Half-and-half nails occur frequently in patients with renal failure and are formed of a white proximal nail portion and a normal pink distal end. Uremic frost can occur on the skin in patients with severe renal failure of long duration. This white coating on the skin is caused by an increased concentration of urea in the sweat. However, long before failure is manifested clinically, specific dermatologic abnormalities can provide clues to the cause of renal disease. We review here the hereditary, metabolic, and vascular disorders that affect both the kidney and skin. The dermatologic manifestations are stressed as important guides to the diagnosis of renal disease.
