Inflammatory Skin Diseases and the Risk of Chronic Kidney Disease – Population-Based Case-control and Cohort analyses

Emerging evidence suggests an association between common inflammatory skin diseases and chronic kidney disease (CKD).To explore the association between CKD stages 3-5 and atopic eczema, psoriasis, rosacea, and hidradenitis suppurativa. We undertook two complementary analyses; a prevalent case-control and a cohort study using routinely collected primary care data (UK Clinical Practice Research Datalink [CPRD]). We matched individuals with CKD3-5 in CPRD on March 2018 with up to five individuals without CKD on GP practice, age and sex. We compared the prevalence of CKD3-5 among individuals with and without each inflammatory skin disease. We included individuals in CPRD with diabetes mellitus (2004-2018) in a cohort analysis to compare the incidence of CKD3-5 among people with and without atopic eczema and psoriasis. There were 56,602 cases with CKD3-5 and 268,305 controls without. Cases were more likely than controls to have a history of atopic eczema (odds ratio [OR] 1.14; 99% confidence interval 1.11-1.17), psoriasis (1.13; 1.08-1.19), or hidradenitis suppuritiva (1.49; 1.19-1.85), but were slightly less likely to have been diagnosed with rosacea (0.91; 0.86-0.95), after adjusting for age, sex, practice (matching factors), index of multiple deprivation, diabetes, smoking, harmful alcohol use and obesity. Results remained similar after adjusting for hypertension and cardiovascular disease. In the cohort with diabetes (N=335,827), there was no evidence that CKD3-5 incidence was associated with atopic eczema or psoriasis. Atopic eczema, psoriasis, and hidradenitis suppurativa are weakly associated with CKD3-5. Future research is needed to elucidate potential mechanisms and clinical significance of our findings.

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