Advertisement

Uremic Frost

  • Kristie Lynn Slivka Delaney
  • Edgar V. Lerma
  • Julia R. Nunley

Abstract

Uremic frost is the white crystalline material found on the skin in the setting of severe azotemia. When blood urea nitrogen (BUN) levels rise, the level of urea in the sweat also rises. When sweat with significantly higher levels of urea evaporates, the urea crystallizes and is deposited on the skin as “uremic frost.” Typically seen with BUN levels > 200, uremic frost was a common dermatologic finding in the pre-dialysis era. Today, however, it is rarely observed. Typically, if found at all today, uremic frost is seen in underdeveloped countries or in patients non-compliant with dialysis. It is generally a clinical diagnosis, but can be confirmed by testing the urea levels of the crystals diluted in a saline solution. The treatment is dialysis and the prognosis is grave, as its presence signifies severe azotemia.

Keywords

Uremic frost End-stage renal disease Urea Crystals Frost Hemodialysis 

References

  1. 1.
    Udayakumar P, Balasubramanian S, Ramalingam KS, Lakshmi C, Srinivas CR, Mathew AC. Cutaneous manifestations in patients with chronic renal failure on hemodialysis. Indian J Dermatol Venereol Leprol. 2006;72(2):119–25. PubMed PMID: 16707817.PubMedCrossRefGoogle Scholar
  2. 2.
    Markova A, Lester J, Wang J, Robinson-Bostom L. Diagnosis of common dermopathies in dialysis patients: a review and update. Semin Dial. 2012;25(4):408–18. PubMed PMID: 22809004.PubMedCrossRefGoogle Scholar
  3. 3.
    Mohan D, Railey M. Uremic frost. Kidney Int. 2012;81(11):1153. PubMed PMID: 22584601.PubMedCrossRefGoogle Scholar
  4. 4.
    Kuo CC, Hung JB, Tsai CW, Chen YM. Uremic frost. CMAJ. 2010;182(17):E800. PubMed PMID: 20696798. Pubmed Central PMCID: 2988568.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Pol-Rodriguez MM, Wanner M, Bhat P, Grossman ME. Uremic frost in a critically ill patient. Kidney Int. 2008;73(6):790. PubMed PMID: 18309352.PubMedCrossRefGoogle Scholar
  6. 6.
    Bhattarai N, Panda M. Uremic frost. Mayo Clin Proc Mayo Clinic. 2008;83(12):1309. PubMed PMID: 19068538.CrossRefGoogle Scholar
  7. 7.
    Falodun O, Ogunbiyi A, Salako B, George AK. Skin changes in patients with chronic renal failure. Saudi J Kidney Dis Transpl. 2011;22(2):268–72. PubMed PMID: 21422624.PubMedGoogle Scholar
  8. 8.
    Walsh SR, Parada NA. Images in clinical medicine. Uremic frost. N Engl J Med. 2005;352(13):e13. PubMed PMID: 15800220.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Kristie Lynn Slivka Delaney
    • 1
  • Edgar V. Lerma
    • 2
  • Julia R. Nunley
    • 3
  1. 1.Internal Medicine, UIC/Advocate Christ Hospital, Advocate Christ Medical CenterOak LawnUSA
  2. 2.Section of Nephrology, Department of Medicine, Advocate Christ Medical CenterUniversity of Illinois at ChicagoOak LawnUSA
  3. 3.Department of DermatologyVirginia Commonwealth University Medical Center, Nelson ClinicRichmondUSA

Personalised recommendations