In the “old days” Caucasian patients on dialysis had complexion that was pale, gray, or even yellow while dark skinned people said that their skin color darkened. Today we see that as patients get longer or more frequent dialysis which removes more toxins than 3 time a week standard dialysis and as we see anemia managed better, this helps people on dialysis look healthier. If your complexion has changed, you might ask your doctor or nurse what your labs show about your dialysis adequacy (Kt/V or URR) and anemia (Hemoglobin or Hematocrit).