CHAPTER ONE
INTRODUCTION
Chronic renal failure refers to substantial, irreversible, progressive, and usually longstanding loss of renal function.
Patients with chronic renal failure (CRF) have a persistently elevated serum creatinine and their renal function moves a downhill course until when renal replacement therapy will be required. According to the Kidney Disease Outcome Quality Initiative (K/DOQI), chronic renal failure refers to stage 5 chronic kidney disease at which point the glomerular filtration rate is less than 15mls/min per 1.73m
and the patient would require renal replacement therapy.
This stage is also known as end stage renal disease. In the United States, data from the US Renal Data system shows that the incidence of chronic renal failure has increased steadily rising from 142 cases per million population in 1987 to 308 cases per million population in the year 2000.
CRF is common among patients attending hospitals in Nigeria as in other parts of the world.
From hospital admission records, chronic renal failure accounted for 8% of medical admissions in Ile-Ife and 7.3% in Ibadan. 5,6 This data shows that the disease is an important one and the health problems relating to it must be given great attention. Chronic renal failure affects people in their prime of life. Many patients with CRF require dialysis at the first time of presentation
. They are often in the nations workforce leading to severe economic and social problems. Among patients on haemodialysis in Ibadan, chronic glomerulonephritis and hypertension were the most frequent causes of CRF with each accounting for 48% and 39% respectively. Nephrotic syndrome accounted for 2% while unclassified conditions accounted for 4%. 8,9
Chronic renal failure is a disease condition that can affect virtually every system in the body. Neurological manifestations include, proximal myopathy, encephalopathy, peripheral neuropathy and tremors.
Cardiac involvement could manifest as hypertension and pericarditis. The respiratory system can also be involved manifesting as pleural effusion, pulmonary edema.
Chronic renal failure presents with an array of skin problems. These contribute to the morbidity and mortality in these patients and should not be overlooked. The dermatological features may arise directly from the kidney impairment, from the underlying disorder causing the kidney impairment or cutaneous disorders related to renal transplant or renal replacement therapy. This study highlights the skin manifestations seen in patients with chronic renal failure in a black population emphasizing the peculiarities in the features seen compared to those documented in studies done from other parts of the world.
