Did you know that kidney disease can cause skin problems like itchy dry skin, rashes, lumps, and swelling? When your kidneys aren’t working properly, waste and toxins build up in your blood, leading to uncomfortable skin changes.

This article will help you identify skin problems linked to kidney disease. We’ll also cover how doctors can treat these symptoms to help you feel more comfortable and improve your quality of life.

How Does Kidney Disease Affect Your Skin?

Your kidneys work nonstop to filter waste and toxins from your blood. But in chronic kidney disease (CKD), the filters in your kidneys are damaged and can’t remove waste properly. As these toxins build up in your bloodstream, they irritate your skin, sometimes causing rashes, itching, and dryness.

Your kidneys also help balance important minerals in your body, including calcium, phosphorus, and sodium. When phosphate levels get too high, your skin can become dry, itchy, and irritated.

Other reasons kidney disease may cause itchy skin or rashes include:

• Loss of sweat glands (which can happen in people on dialysis, making it harder to stay cool)
• High parathyroid hormone (PTH) levels (which can affect skin and bone health)
• High levels of certain minerals and metals (like aluminum or magnesium, which can build up in the blood)
• Missing or inadequate dialysis treatments (leading to more waste buildup in your body)

Kidney Disease Rashes and Skin Symptoms

Kidney rashes may appear as bumps, rough patches, or blisters. Other problems associated with CKD include nail changes, skin color changes, and abnormal skin thickening.

Itchy Skin Rashes

One of the most common skin problems in CKD is dry, itchy skin rashes. Not everyone’s symptoms look the same. Some people have very dry, tight-feeling skin that easily cracks. Others develop dome-shaped bumps. When these bumps group together, they can form large, raised patches of rough skin.

In CKD, waste products like urea build up in the blood — a condition called uremia. This can cause intense itching, known as uremic pruritus. The itching can happen anywhere on your body, but it’s most common on your:

• Face
• Back
• The arm with your dialysis fistula (known as your shunt arm)

Itching sensations from CKD feel like a crawling or prickling sensation underneath your skin. The feelings come and go throughout the day. You might be tempted to scratch, but it usually doesn’t help relieve the discomfort.

Some ways to stop itching include using moisturizer, cool compresses, or medications prescribed by your doctor. Some people notice their symptoms worsen on hot days or when they’re trying to sleep.

Dry, itchy skin is a common symptom affecting people with end-stage kidney disease (kidney failure). It tends to affect those who have dialysis to treat their kidney disease the most. The Cleveland Clinic notes that around 70 percent of people on hemodialysis have itchy skin.

Skin Blisters

End-stage kidney disease can also cause open sores or blisters, which may scab after breaking. Common places for sores to appear include your feet, hands, and face.

Color Changes in Your Skin

Toxin and waste product buildup in your blood can affect the color of your skin. You may notice your skin is paler than normal or has an abnormal yellow or gray hue. Darker patches of skin are also common.

If you scratch or pick at your skin for a long time, you may develop thicker areas of yellow skin. These areas can have deep lines or bumps. Fluid-filled cysts or bumps that look like whiteheads from acne can develop as well.

Rarely, in about 1 percent to 3 percent of people with CKD, the skin may show a frosted appearance. This condition, called uremic frost, occurs when tiny yellow-white urea crystals (a waste product of protein breakdown) build up on the skin. It happens when high urea levels in the blood move through the sweat glands and settle on the skin.

Calcium Deposits Underneath the Skin

Your kidneys help balance important minerals in your body, including calcium. When calcium levels get too high, small lumps or deposits can form under your skin.

These calcium deposits often appear near joints like the elbows and knees and are usually painless. However, deposits on the fingertips tend to be more painful. In some cases, the lumps push through the skin, releasing a white, chalky discharge.

Nail Changes

Your fingernails and toenails can provide clues about your overall health. Studies show that 30 percent to 60 percent of people with CKD develop nail problems. The American Academy of Dermatology explains that signs of kidney disease affecting your nails include:

• Pale-colored nails
• “Half-and-half” nails — White coloring along the top, with brown or red tint near the bottom
• Muehrcke lines (also called Muehrcke nails) — White bands stretching across the nail

New Skin Thickening and Tightness

If you’ve had a magnetic resonance imaging (MRI) scan for your kidney disease, you may be at risk for a rare skin condition called nephrogenic systemic fibrosis (NSF). This condition is linked to gadolinium, a contrast dye used to improve MRI images.

NSF can cause several skin symptoms, like:

• Skin swelling, pain, and itchiness
• Changes in skin color to shades of brown, red, or blue
• Hard, shiny skin that feels extremely tight
• Trouble bending your joints from tight skin

NSF symptoms most often develop on the legs, arms, and abdomen. It’s important to note that NSF is a rare condition, and not everyone who receives gadolinium-based contrast dye will develop it.

Diagnosing and Treating Kidney Disease Skin Rashes

If you notice any new or worsening skin problems with CKD, be sure to talk to your doctor. It may be a warning sign that your kidney disease is progressing. Your nephrologist (kidney specialist) or dermatologist (skin specialist) can suggest treatment options to address rashes and itching. These can include prescription medications and store-bought products. They’ll also offer tips on managing other symptoms of CKD affecting your eyes and tongue.

Diagnosing Skin Problems With Kidney Disease

Your doctor will start by checking your skin during a physical exam, focusing on commonly affected places like your shunt arm, legs, and back. They will also ask about your symptoms and what triggers make them worse.

Some conditions may need a skin biopsy to confirm a diagnosis. This test involves taking a small piece of tissue to look at under a microscope. Many skin condition symptoms overlap with one another. A biopsy helps doctors make the right diagnosis. Blood tests help rule out other conditions as well.

Over-the-Counter Remedies

Your doctor may also recommend moisturizing products to relieve dry, itchy skin. Emollients (thick creams and lotions) create barriers that trap water to soften your skin. You can also find products that contain ingredients designed to relieve itching and pain. Be sure to apply lotions and creams right after getting out of the shower or bath. This helps hold moisture in your skin.

Allergy pills or antihistamines aren’t just for your springtime sneezing. They can also help address skin itching and discomfort from CKD. Some antihistamines can make you drowsy, which can help you fall asleep more easily if you have nighttime itching. Look for newer medications like loratadine (Claritin) to use during the day.

Prescription Treatments

If over-the-counter options don’t help control your symptoms, prescription treatments are available as well. Certain nerve pain medications help calm the nerves that are sending signals to itch your skin. Examples include pregabalin and gabapentin.

Another class of medications — called kappa-opioid agonists — block nerve signals to reduce itchiness as well. The U.S. Food and Drug Administration (FDA) approved difelikefalin (Korsuva) for treating itchy skin in adults with CKD undergoing hemodialysis. Your provider gives this medication intravenously (through your vein) during your dialysis treatment.

Phototherapy uses ultraviolet B (UVB) rays to treat skin rashes, inflammation, and itching. This is an option for people who don’t respond to other treatments. Phototherapy is also useful for people who can’t receive a kidney transplant to manage their CKD.

If your symptoms are caused by inadequate dialysis, your doctor may adjust your treatment to improve waste removal.

Speak With Your Doctor About Skin Changes

Skin problems like rashes, itching, and discoloration can be frustrating symptoms of kidney disease, but treatment options are available. If you notice new or worsening skin issues, talk to your doctor, nephrologist, or dermatologist. They can help identify the cause and recommend medications, skincare products, or adjustments to your dialysis treatment. Managing your kidney health is key to reducing symptoms and improving your comfort and quality of life.

Talk With Others Who Understand

On MyKidneyDiseaseTeam, people with kidney disease and their loved ones come together to ask questions, give advice, and share their stories with others who understand life with kidney disease.

Are you living with chronic kidney disease? Have you had skin rashes, color changes, or other noticeable problems? How has your kidney doctor managed them? Has a dermatologist helped you? Share your story in the comments below, start a conversation by posting on your Activities page, or connect with like-minded people in Groups.