Background: Xerosis is a common skin manifestation in chronic renal disease. Itching from dry skin causes skin discomfort, scratch marks, and compromises skin barrier function.

Objective: To compare the efficacy of moisturizer containing 5% urea, natural moisturizing factors (NMFs), ceramide, and glyceryl glucoside (GG) with 5% urea lotion for treatment of xerosis in patients with underlying stable chronic kidney disease.

Material and Method: We performed a randomized, double-blind, split-side, experimental study in 50 children with xerosis in stable chronic kidney disease. The patients were assigned sequentially by block randomization to use either moisturizing lotion containing 5% urea, NMFs, ceramide, and GG or 5% urea on opposite sides of the lower leg, twice daily for four weeks. The moisturizers were repacked in identical bottles. Clinical severity of xerosis, skin hydration, and transepidermal water loss (TEWL) were evaluated at baseline and at at one, two, and four weeks.

Results: Forty-seven of 50 patients completed the study. The mean age was 13.43±2.3years. Both products significantly decreased clinical severity of scaling and roughness from baseline (p<0.001). Application of moisturizer containing 5% urea, NMFs, ceramide, and GG resulted in significantly higher skin hydration and lower TEWL compared with 5% urea lotion (both p<0.01), from week 1. Regarding the safety of using urea in chronic kidney disease, there were no significant differences in blood urea nitrogen (BUN) and creatinine levels between pre- and post-treatment (p = 0.627). No adverse effects were reported.

Conclusion: Both moisturizing lotions containing 5% urea, NMFs, ceramide, and GG and 5% urea were effective in improving scaling and roughness, skin hydration, and skin barrier function in stable chronic pediatric kidney disease patients. Additional ingredients, such as NMFs, ceramide, and GG can significantly improve xerosis, skin hydration, and skin barrier function. Products containing 5% urea applied on the lower legs for four weeks do not increase BUN or creatinine levels.

Keywords: Xerosis, Glyceryl glucoside, Pediatric