Wild Johannes, Keller Karsten, Karbach Susanne, Weinmann-Menke Julia, Münzel Thomas, Hobohm Lukas
Department of Cardiology, Cardiology I, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany.
Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany.
J Clin Med. 2022 Jul 26;11(15):4328. doi: 10.3390/jcm11154328.
Background and Objectives: During the last decades, growing evidence corroborates that chronic inflammatory disease impairs the body beyond the cutaneous barrier. Linkage between psoriasis and kidney disease, and in particular between psoriasis and end-stage renal disease (ESRD), have not yet been elucidated. We sought to analyze the impact of concomitant psoriasis on the in-hospital outcomes of patients hospitalized with ESRD. Patients and Methods: We analyzed data on characteristics, comorbidities, and in-hospital outcomes of all hospitalized patients with ESRD stratified for concomitant psoriasis in the German nationwide in-patient sample between 2010 and 2020. Results: Overall, 360,980 hospitalizations of patients treated for ESRD in German hospitals were identified from 2010 to 2020 and among these 1063 patients (0.3%) additionally suffered from psoriasis. While the annual number of all ESRD patients increased within this time, the number of patients with ESRD and the additional psoriasis diagnosis decreased slightly. Patients with ESRD and psoriasis were five years younger (66 [IQR, 56−75] vs. 71 [59−79] years, p < 0.001), were more often obese (17.5% vs. 8.2%, p < 0.001) and more frequently had cancer (4.9% vs. 3.3%, p < 0.001), diabetes mellitus (42.7% vs. 38.5%, p = 0.005) and coronary artery disease (31.1% vs. 28.0%, p = 0.026). Multivariate regression models demonstrated that psoriasis was not associated with in-hospital case-fatality in patients with ESRD (OR 1.02 (95%CI 0.78−1.33), p = 0.915). Conclusions: ESRD patients with the concomitant psoriasis diagnosis were hospitalized on average 5 years earlier than patients without psoriasis. A higher prevalence of severe life-shortening comorbidities including coronary artery disease and cancer was detected in ESRD patients with psoriasis despite their younger age. Our findings support the understanding of psoriasis as an autoimmune skin disease crossing the boundary between dermatology and internal medicine.
在过去几十年中，越来越多的证据证实，慢性炎症性疾病对身体的损害超出了皮肤屏障。银屑病与肾脏疾病之间的联系，尤其是银屑病与终末期肾病（ESRD）之间的联系，尚未阐明。我们试图分析合并银屑病对ESRD住院患者院内结局的影响。
我们分析了2010年至2020年德国全国住院患者样本中所有因ESRD住院患者的特征、合并症和院内结局数据，并根据是否合并银屑病进行分层。
总体而言，2010年至2020年期间，德国医院共确定了360,980例接受ESRD治疗的患者住院，其中1063例（0.3%）还患有银屑病。在此期间，所有ESRD患者的年住院人数有所增加，而合并银屑病诊断的ESRD患者人数略有下降。合并ESRD和银屑病的患者比无银屑病患者年轻5岁（66岁[四分位间距，56 - 75岁]对71岁[59 - 79岁]，p <(0.001)），肥胖的比例更高（17.5%对8.2%，p <(0.001)），患癌症（4.9%对3.3%，p <(0.001)）、糖尿病（42.7%对38.5%，p = (0.005)）和冠状动脉疾病（31.1%对28.0%，p = (0.026)）的频率也更高。多变量回归模型表明，银屑病与ESRD患者的院内病死率无关（比值比1.02[95%置信区间0.78 - 1.33]，p = (0.915)）。
合并银屑病诊断的ESRD患者比无银屑病患者平均早5年住院。尽管合并银屑病的ESRD患者年龄较小，但他们中包括冠状动脉疾病和癌症在内的严重缩短寿命的合并症患病率更高。我们的研究结果支持将银屑病理解为一种跨越皮肤科和内科界限的自身免疫性皮肤病。
