The relationship of dermatological findingswithserum il-31 and serum udp glucose ceramide glucosyl transferase levels among chronic kidney disease patients

Cutaneous diseases are seen in chronıc kidney disease (CKD) patients with increasing duration and severity of renal disease. The aim of this study was to study and compare dermatological manifestations in patients with various stages of CKD and relationship of these manifestations with T cell cytokine that has been known to induce severe pruritus: IL-31 and ceramide (which play an important role in moisturizing epidermis) metabolizing enzyme: UDP glucose ceramide glucosyl transferase (UGCG) . 145 patients with mean age of 46±17 years were recruited into this study. Study groups were Group 1, Hemodialysis group (consisting of 30 patients on chronic hemodialysis programme for 49±44 months), Group 2, peritoneal dialysis group (26 patients on chronic peritoneal dialysis programme for 43±37 months), Group 3, kıdney transplant group (30 patients with functioning kidney allografts-average lifespan of which were 34±50 months-with mean serum creatinine levels of 1.48±0.99 mg/dl), Group 4 chronic kidney disease group (29 patients with chronic kidney disease stage 1 or 5-with a mean serum creatinine levels of 4.56±2.56 mg/dl), Group 5 control group (30 healthy individuals with serum creatinine levels of 0.67±0.25 mg/dl). Serum IL-31,UGCG levels of all of the groups were measured using ELISA methodology. Dermatological manifestations of the patients were evaluated by clinical dermatologists. When all the data evaluated, it was found that itching was significantly and inversely correlated with glomerular filtration rate, serum hemoglobin and albumin levels (p<0.005). When groups were analyzed, presence of pruritus was significantly higher in group 2 compared to control group; while it was significantly lower in group 3 compared to group 1, 2 and 4 (p<0.05). The groups had differed with respect to xerosis, pigmentation and alopecia. There was no was significant difference with respect to serum IL-31, UGCG levels between the groups. However, patients in group 4 with nail longitudinal ridges were observed to have significantly higher IL-31 levels compared to those without longitudinal ridges in their nails. In addition, patients in group 2 with pruritus were found to have significantly lower UGCG levels compared to those without pruritus (p<0.05). Lastly patients in group 4 with xerosis were found to have levels compared to those without xerosis (p<0.05). IL-31 might play a role in nail longitudinal ridges development, while UGCG might be protective from pruritus and xerosis in CKD patients.