A Porphyria Cutanea Tarda-like Distribution Pattern of Porphyrins in Plasma, Hemodialysate, Hemofiltrate, and Urine of Patients on Chronic Hemodialysis

The porphyrin investigations of plasma, dialysate, hemofiltrate, and urine in 50 chronic renal patients without bullae undergoing hemodialysis imply that a hyperporphyria exists. All 50 dialysis patients without blisters had significantly elevated plasma porphyrins with a mean of 27.4 μg/liter (SD: 10.0). Normal values were established in 51 nonporphyric ambulatory patients with normal renal function. The mean plasma porphyrin content in this group was 10.6 μg/liter (SD: 1.7). Porphyrin values in dialysates of 41 patients with chronic renal failure ranged from 2.6-6.3 μg/liter (mean, 3.9 μg/liter) and were much lower than the porphyrin content in hemofiltrates of 9 patients which ranged from 10–27 μg/liter with a mean of 20 μg/liter. In addition, plasma, hemofiltrate, and urine of 5 dialysis patients with blisters and porphyria cutanea tarda (PCT) were investigated. The plasma values were extremely elevated and exceeded those of PCT patients with normal renal function. Whether the dermatologic manifestations of chronic hemodialysis can be interpreted as a “forme fruste” of PCT should be subjected to further investigations