Abstract
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.
Material and 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 6841 (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.
Key Indexing Terms
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Article info
Publication history
Published online: March 11, 2022
Accepted:
March 8,
2022
Received:
July 11,
2021
Identification
Copyright
Published by Elsevier Inc. on behalf of Southern Society for Clinical Investigation.
