Abstract:
BACKGROUND:Psoriasis is a chronic inflammatory dermatosis that has been associated with various cardiovascular and metabolic comorbidities, including myocardial infarction, stroke, and diabetes mellitus. Recently, there are studies reporting the association of psoriasis with renal diseases. OBJECTIVE:To evaluate the risk of incident chronic kidney disease (CKD) and end-stage renal disease (ESRD) in people with psoriasis. METHODS:We used the Taiwan's National Health Insurance Research Database to conduct a nationwide population-based cohort study to assess the risk of incident CKD and ESRD in people with psoriasis and to further evaluate the respective risk estimates in those with mild and severe psoriasis based on treatment patterns. RESULTS:A total of 4633 psoriatic patients and 922,534 nonpsoriatic controls were included. Severe psoriasis, but not mild psoriasis, was an independent risk factor of incident CKD and ESRD (adjusted hazard ratio being 1.90 (95% confidence interval 1.33-2.70) and 2.97 (95% confidence interval 1.72-5.11), respectively) after adjustment for potential confounders including age, gender, comorbidities, and used of nonsteroidal anti-inflammatory drugs (NSAIDs). Severe psoriasis remained an independent risk factor of incident CKD and ESRD after various sensitivity analyses after adjusting for the presence of osteoarthritis and/or rheumatoid arthritis, use of methotrexate and/or cyclosporine, and chronic use of NSAIDs for at least 2 months. Psoriatic arthritis was an effect modifier for CKD and ESRD. CONCLUSIONS:The associations of severe psoriasis with CKD and ESRD should be recognized. Assessment of renal function and avoidance of long-term use of nephrotoxic drugs shall be implemented in the integrative care for patients with severe psoriasis.
journal_name
J Dermatol Scijournal_title
Journal of dermatological scienceauthors
Chi CC,Wang J,Chen YF,Wang SH,Chen FL,Tung THdoi
10.1016/j.jdermsci.2015.03.012subject
Has Abstractpub_date
2015-06-01 00:00:00pages
232-8issue
3eissn
0923-1811issn
1873-569Xpii
S0923-1811(15)00112-7journal_volume
78pub_type
杂志文章abstract:BACKGROUND:Atopic dermatitis is a common skin disease characterized by a Th2 cell-dominant inflammatory infiltrate, elevated serum IgE levels and impaired epidermal barrier function. It is associated to abnormal epidermal lamellar body secretion, producing alteration in lipid composition and extracellular lamellar memb...
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