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Open Access Research article

The prevalance, epidemiology and risk factors for onychomycosis in hemodialysis patients

Güven Kuvandik1, Meryem Çetin2, Gultekin Genctoy3*, Mehmet Horoz3, Mehmet Duru1, Cenk Akcali4, Salim Satar5, Ahmet A Kiykim3 and Hasan Kaya6

Author Affiliations

1 Mustafa Kemal University, Faculty of Medicine, Department of Emergency Medicine, Hatay, Turkey

2 Mustafa Kemal University, Faculty of Medicine, Department of Microbyology and Clinical Microbyology, Hatay, Turkey

3 Mersin University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Mersin, Turkey

4 Mustafa Kemal University, Faculty of Medicine, Department of Dermatology, Hatay, Turkey

5 Cukurova University, Faculty of Medicine, Department of Emergency, Adana, Turkey

6 Mustafa Kemal University, Faculty of Medicine, Department of Internal Medicine, Hatay, Turkey

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BMC Infectious Diseases 2007, 7:102  doi:10.1186/1471-2334-7-102

Published: 30 August 2007

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.

Conclusion

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.