Wounds caused by the effects of Dialysis

[jelamrn]

Im over the wound care dept @ a LTC facility. One of my pt.'s who receives dialysis keeps getting theses clusters of scabs here and there, usually on her arms, and sometimes on her chest or back. This week the areas started to come up on on her right calf and she is complaining of pain @ theses sites. There was one scab there yesterday and today there are 6. She says they have always told her that its from the dialysis and that she's been to a dermatologist but nothing has ever helped. Does anybody have any experience with this type of skin issue?

[justatraveler]

Originally Posted by jelamrn

Im over the wound care dept @ a LTC facility. One of my pt.'s who receives dialysis keeps getting theses clusters of scabs here and there, usually on her arms, and sometimes on her chest or back. This week the areas started to come up on on her right calf and she is complaining of pain @ theses sites. There was one scab there yesterday and today there are 6. She says they have always told her that its from the dialysis and that she's been to a dermatologist but nothing has ever helped. Does anybody have any experience with this type of skin issue?

Do the areas itch? If so her Phosphorus is probably high. Be sure she is taking her Phosphate Binders. i.e. phos-lo, renagel, or possibly tums, with her meals. Also, check with the dialysis nurses to see if her lab work has caused them to increase her phosphate binders and that information hasn't been passed along to the LTC center.

Is she a diabetic as I see the same thing on many DM patients. I think they scratch and get those "sores" because of their diabetes, maybe thin skin as in the elderly.

Just to be on the safe side I'd call the dialysis unit and ask if she has been assessed for a disease called calciphlaxis. A horrible thing. Can be fatal.

One other thought is because of fluid restriction many dialysis patients have dry skin. Maybe a good moisterizer would help.