Advanced chronic kidney disease can sometimes be associated with changes in skin pigmentation.
NIDDK lists **darkened skin** among symptoms that may occur as CKD becomes more advanced.
The skin may appear:
* Darker than usual
* Dull or grayish
* Uneven in tone
However, changes in pigmentation have many possible causes and are not specific to kidney disease.
A persistent or unexplained change in skin color should be evaluated based on the person’s overall health, medications, sun exposure, and other symptoms.
## 4. Puffiness Around the Eyes
