TY - JOUR
T1 - Risk of incident chronic kidney disease and end-stage renal disease in patients with psoriasis
T2 - A nationwide population-based cohort study
AU - Chi, Ching Chi
AU - Wang, Jui
AU - Chen, Yu Fen
AU - Wang, Shu Hui
AU - Chen, Fu Li
AU - Tung, Tao Hsin
N1 - Publisher Copyright:
© 2015.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - 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.
AB - 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.
KW - Chronic kidney disease
KW - End-stage renal disease
KW - Psoriasis
KW - Psoriatic arthritis
UR - http://www.scopus.com/inward/record.url?scp=84929043044&partnerID=8YFLogxK
U2 - 10.1016/j.jdermsci.2015.03.012
DO - 10.1016/j.jdermsci.2015.03.012
M3 - 文章
C2 - 25862150
AN - SCOPUS:84929043044
SN - 0923-1811
VL - 78
SP - 232
EP - 238
JO - Journal of Dermatological Science
JF - Journal of Dermatological Science
IS - 3
ER -