Yu Wen-Ting, Ma Sheng-Hsiang, Wu Chun-Ying, Chen Yen-Ling, Chang Yun-Ting, Wu Chen-Yi
Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.
J Dtsch Dermatol Ges. 2023 Dec;21(12):1480-1487. doi: 10.1111/ddg.15219. Epub 2023 Oct 13.
Studies have shown that bullous pemphigoid (BP) occurs in patients with chronic kidney disease (CKD). However, the risk of developing BP in patients with CKD remains inconclusive.
To investigate whether CKD increases the risk of BP.
Participants were recruited from the National Health Insurance Database of Taiwan between 2007 and 2018. Overall, 637,664 newly diagnosed patients with CKD and 637,664 age-, sex-, and comorbidity-matched non-CKD participants were selected. A competing risk model was used to evaluate the risk of development of BP.
After adjusting for age, sex, and comorbid diseases in the multivariate model, CKD was a significant risk factor for BP (adjusted hazard ratio [aHR]: 1.29; 95% confidence interval [CI]: 1.17-1.42; p < 0.001). CKD patients were classified into the dialytic or non-dialytic groups and compared to non-CKD participants, and this revealed that patients with dialysis-dependent CKD had the highest risk of BP (aHR 1.75; 95% CI 1.51-2.03), followed by patients with non-dialysis-dependent CKD (aHR 1.20; 95% CI 1.08-1.32).
We lacked detailed laboratory data on the severity of CKD.
Compared with individuals without CKD, those with CKD had a 1.3-fold increased risk of BP. Patients with dialysis-dependent CKD had an even higher BP risk (1.8-fold).
研究表明，慢性肾脏病（CKD）患者会发生大疱性类天疱疮（BP）。然而，CKD患者发生BP的风险仍无定论。
研究CKD是否会增加BP发生风险。
研究对象来自2007年至2018年台湾地区国民健康保险数据库。共选取637,664例新诊断的CKD患者以及637,664例年龄、性别和合并症相匹配的非CKD参与者。采用竞争风险模型评估BP发生风险。
在多变量模型中对年龄、性别和合并疾病进行校正后，CKD是BP的显著危险因素（校正风险比[aHR]：1.29；95%置信区间[CI]：1.17 - 1.42；p < 0.001）。将CKD患者分为透析组和非透析组，并与非CKD参与者进行比较，结果显示依赖透析的CKD患者发生BP的风险最高（aHR 1.75；95% CI 1.51 - 2.03），其次是非依赖透析的CKD患者（aHR 1.20；95% CI 1.08 - 1.32）。
我们缺乏关于CKD严重程度的详细实验室数据。
与非CKD个体相比，CKD患者发生BP的风险增加了1.3倍。依赖透析的CKD患者发生BP的风险更高（1.8倍）。
