The prevalance, epidemiology and risk factors for onychomycosis in hemodialysis patients.
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.
Kuvandik
Güven
G
Mustafa Kemal University, Faculty of Medicine, Department of Emergency Medicine, Hatay, Turkey. guvenkuvandik@yahoo.com
Cetin
Meryem
M
Genctoy
Gultekin
G
Horoz
Mehmet
M
Duru
Mehmet
M
Akcali
Cenk
C
Satar
Salim
S
Kiykim
Ahmet A
AA
Kaya
Hasan
H
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