TY - JOUR
T1 - Psoriasis and Pneumonia in the End-stage Renal Disease Population
AU - Aitkens, Lorry
AU - Waller, Jennifer L
AU - Baer, Stephanie L
AU - Mohammed, Azeem
AU - Tran, Sarah
AU - Siddiqui, Budder
AU - Padala, Sandeep
AU - Young, Lufei
AU - Kheda, Mufaddal
AU - Bollag, Wendy B
N1 - Funding Information:
This work was supported by the AU Department of Medicine Translational Research Program, a grant from Dialysis Clinic, Inc., and the Carolyn L. Kuckein Student Research Fellowship Program. The contents of this article do not represent the views of the Department of Veterans Affairs or the United States Government. The data reported here have been supplied by the USRDS (U.S. Renal Data System. 2017 USRDS annual data report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2017). The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as official policy or interpretation of the United States Government.
Funding Information:
DCI Reserve Funds Project Number: C-3953 (081 – East Albany). WBB was supported by VA Merit #CX001357 and a VA Research Career Scientist Award (#BX005691).
Publisher Copyright:
© 2022
PY - 2022/3
Y1 - 2022/3
N2 - BACKGROUND: Psoriasis is a common chronic inflammatory skin disease associated with an increased risk for acute infections. Because chronic kidney disease is a risk factor for pneumonia, end-stage renal disease (ESRD) patients with psoriasis may have an increased risk for acquiring pneumonia.METHODS: A retrospective cohort analysis was performed using the United States Renal Data System, a medical claims database of all ESRD patients undergoing dialysis in the US. Logistic regression analysis was used to investigate the association of psoriasis with pneumonia in ESRD patients.RESULTS: A total of 6,841 (0.7%) ESRD patients were diagnosed with psoriasis; 385,976 (36%) ESRD patients had pneumonia. Although simple models showed that psoriasis was associated with an increased risk of pneumonia in the ESRD population (odds ratio (OR) = 1.14), the final multivariable model found that psoriasis was protective for pneumonia (OR = 0.56) when controlling for age, race, sex, ethnicity, dialysis modality, Charlson Comorbidity Index (CCI), multiple sclerosis, tobacco use and alcohol use. This is due to both the CCI and tobacco use being strong confounders of the association of psoriasis and pneumonia. Black, other race and Hispanic ethnicity were also protective for pneumonia, while increasing age and CCI, female sex, hemodialysis, multiple sclerosis and tobacco and alcohol use were associated with increased risk.CONCLUSIONS: When controlling for multiple factors, psoriasis does not increase the risk for pneumonia in ESRD patients. In this cohort, other factors, such as the CCI and tobacco use, were more strongly associated with increased risk for pneumonia than psoriasis.
AB - BACKGROUND: Psoriasis is a common chronic inflammatory skin disease associated with an increased risk for acute infections. Because chronic kidney disease is a risk factor for pneumonia, end-stage renal disease (ESRD) patients with psoriasis may have an increased risk for acquiring pneumonia.METHODS: A retrospective cohort analysis was performed using the United States Renal Data System, a medical claims database of all ESRD patients undergoing dialysis in the US. Logistic regression analysis was used to investigate the association of psoriasis with pneumonia in ESRD patients.RESULTS: A total of 6,841 (0.7%) ESRD patients were diagnosed with psoriasis; 385,976 (36%) ESRD patients had pneumonia. Although simple models showed that psoriasis was associated with an increased risk of pneumonia in the ESRD population (odds ratio (OR) = 1.14), the final multivariable model found that psoriasis was protective for pneumonia (OR = 0.56) when controlling for age, race, sex, ethnicity, dialysis modality, Charlson Comorbidity Index (CCI), multiple sclerosis, tobacco use and alcohol use. This is due to both the CCI and tobacco use being strong confounders of the association of psoriasis and pneumonia. Black, other race and Hispanic ethnicity were also protective for pneumonia, while increasing age and CCI, female sex, hemodialysis, multiple sclerosis and tobacco and alcohol use were associated with increased risk.CONCLUSIONS: When controlling for multiple factors, psoriasis does not increase the risk for pneumonia in ESRD patients. In this cohort, other factors, such as the CCI and tobacco use, were more strongly associated with increased risk for pneumonia than psoriasis.
KW - Chronic kidney disease
KW - Pneumonia
KW - Psoriasis
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U2 - 10.1016/j.amjms.2022.03.002
DO - 10.1016/j.amjms.2022.03.002
M3 - Article
C2 - 35289277
SN - 0002-9629
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
ER -