The disease first manifests as painless nodular thickenings of the palmar aponeurosis that adhere to the skin. It is often encountered in uremic patients.

The description you provided suggests a condition known as Dupuytren's contracture. This is a hand deformity that typically starts with thickening and shortening of the palmar fascia, which leads to the formation of nodules and, eventually, to contractures of the fingers. Dupuytren's contracture is more prevalent in individuals with certain risk factors, including older age, male gender, family history, and certain health conditions like diabetes or liver disease, which is often associated with uremia.

In uremic patients, the development of this condition can be linked to metabolic changes and tissue responses associated with kidney failure, leading to fibrosis in the palmar fascia. Although it is painless, the progression can limit the functional capacity of the hand, necessitating intervention in more advanced cases, which may include surgical procedures to release the contracted fingers.

In summary, Dupuytren's contracture is characterized by painless nodular thickenings of the palmar aponeurosis, commonly associated with uremic patients, and may require surgical intervention if it leads to significant functional impairment.