title: The prevalance, epidemiology and risk factors for onychomycosis in hemodialysis patients.
abstract: BACKGROUND
  Onychomycosis has a high prevalance among immunocompromised patients such as diabetics and hemodialysis patients. In the present study, we aimed to investigate the prevalence of onychomycosis among hemodialysis patients with and without diabetes mellitus, and to find out the factors likely to be associated with the development of onychomycosis among hemodialysis patients.
  
  
  METHODS
  One hundred and nine hemodialysis patients were enrolled. Fifty-seven of hemodialysis patients had the diagnosis of diabetes mellitus. Nail scrapings were obtained from 76 patients who had dystrophic nail changes. Samples were examined with 20% potassium hydroxide solution and all of the samples were inoculated on Saboraud's dextrose agar, potateus dextrose agar and mycobiotic agar. Diagnosis of onychomycosis was based on the presence of both positive clinical signs and positive potassium hydroxide test.
  
  
  RESULTS
  Onychomycosis was diagnosed in 26.6% of hemodialysis patients. Diabetes mellitus was present in 68.9% of patients with onychomycosis. Toenail scraping cultures were reported to be positive in 19.7% of patients with dystrophic nail changes. Logistic regression analysis revealed that the presence of diabetes mellitus and the mean duration of hemodialysis were the significant predictors associated with the development of onychomycosis.
  
  
  CONCLUSIONS
  The prevalence of dystrophic nail changes and onychomycosis is increased among hemodialysis patients. The dialysis duration and the presence of diabetes mellitus are the independent risk factors associated with the development of onychomycosis in uraemic patients.
authors.affiliation: Mustafa Kemal University, Faculty of Medicine, Department of Emergency Medicine, Hatay, Turkey. guvenkuvandik@yahoo.com
authors.forename: Güven
authors.initials: G
authors.lastname: Kuvandik
authors.forename: Meryem
authors.initials: M
authors.lastname: Cetin
authors.forename: Gultekin
authors.initials: G
authors.lastname: Genctoy
authors.forename: Mehmet
authors.initials: M
authors.lastname: Horoz
authors.forename: Mehmet
authors.initials: M
authors.lastname: Duru
authors.forename: Cenk
authors.initials: C
authors.lastname: Akcali
authors.forename: Salim
authors.initials: S
authors.lastname: Satar
authors.forename: Ahmet A
authors.initials: AA
authors.lastname: Kiykim
authors.forename: Hasan
authors.initials: H
authors.lastname: Kaya
mesh_terms: D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000473:pathology; D003928:Diabetic Nephropathies / Q000150:complications; D005260:Female; D005533:Foot Dermatoses / Q000453:epidemiology*; D005658:Fungi / Q000145:classification / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D014009:Onychomycosis / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000209:etiology / Q000628:therapy; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology