Risk of moderate to advanced kidney disease in patients with psoriasis: population based cohort study.
Risk of moderate to advanced kidney disease in patients with psoriasis: population based cohort study.
复制标题
DOI：
10.1136/bmj.f5961
复制
发表时间：
2013-10-15
期刊：
影响因子：
--
通讯作者：
Gelfand JM
中科院分区：
文献类型：
--
作者：
Wan J;Wang S;Haynes K;Denburg MR;Shin DB;Gelfand JM
目的探讨银屑病患者发生慢性肾脏病的危险性。设计基于人群的队列研究和巢式横断面研究。建立电子病历数据库，总部设在英国。参与者队列研究：根据年龄、实践和就诊时间，18-90岁的银屑病患者与最多5名非银屑病患者相匹配。巢式研究：年龄在25-64岁的银屑病患者，具有银屑病严重程度的确认数据，每个患者与最多10名基于年龄和实践的无银屑病患者匹配。主要结果测量队列研究：中晚期（3 - 5期）慢性肾脏疾病事件。巢式研究：慢性肾脏疾病的基线患病率。结果136529例轻度银屑病患者和7354例重度银屑病患者根据治疗模式与689702例未受影响的患者相匹配。在总体、轻度和重度银屑病组中，发生慢性肾脏疾病的校正风险比（95%置信区间）分别为1.05（1.02 - 1.07）、0.99（0.97 - 1.02）和1.93（1.79 - 2.08）。在重度银屑病组中，年龄是一个显著的影响因素，30岁和60岁患者的年龄特异性校正风险比（95%置信区间）分别为3.82（3.15 - 4.64）和2.00（1.86 - 2.17）。在巢式分析中，8731例银屑病患者与87310例非银屑病患者的受影响体表面积测量结果相匹配，校正后的比值比慢性肾脏疾病的95%置信区间为0.89（0.72 ~ 1.10）、1.36（1.06 ~ 1.74）和1.58（1.07 ~ 2.34）。结论中重度银屑病与慢性肾脏病风险增加相关，与传统的风险因素无关。
Objective To determine the risk of chronic kidney disease in patients with psoriasis. Design Population based cohort study and nested cross sectional study. Setting Electronic medical records database based in United Kingdom. Participants Cohort study: patients with psoriasis aged 18-90 each matched to up to five patients without psoriasis based on age, practice, and time of visit. Nested study: patients with psoriasis aged 25-64 with confirmed data on psoriasis severity, each matched to up to 10 patients without psoriasis based on age and practice. Main outcome measures Cohort study: incident moderate to advanced (stage 3 through 5) chronic kidney disease. Nested study: baseline prevalence of chronic kidney disease. Results 136 529 patients with mild psoriasis and 7354 patients with severe psoriasis based on treatment patterns were matched to 689 702 unaffected patients. The adjusted hazard ratios (95% confidence intervals) for incident chronic kidney disease were 1.05 (1.02 to 1.07), 0.99 (0.97 to 1.02), and 1.93 (1.79 to 2.08) in the overall, mild, and severe psoriasis groups, respectively. Age was a significant effect modifier in the severe psoriasis group, with age specific adjusted hazard ratios (95% confidence intervals) of 3.82 (3.15 to 4.64) and 2.00 (1.86 to 2.17) for patients aged 30 and 60, respectively. In the nested analysis of 8731 patients with psoriasis with measurements of affected body surface area matched to 87 310 patients without psoriasis, the adjusted odds ratios (95% confidence intervals) for chronic kidney disease were 0.89 (0.72 to 1.10), 1.36 (1.06 to 1.74), and 1.58 (1.07 to 2.34) in the mild, moderate, and severe psoriasis groups, respectively. Conclusions Moderate to severe psoriasis is associated with an increased risk of chronic kidney disease independent of traditional risk factors.
登录
查看更多内容
影响因子：
120.7
作者：
Gelfand, Joel M.;Neimann, Andrea L.;Troxel, Andrea B.
通讯作者：
Troxel, Andrea B.
影响因子：
10.3
作者：
Dommasch, E. D.;Shin, D. B.;Gelfand, J. M.
通讯作者：
Gelfand, J. M.
DOI：
10.1111/j.1365-2133.2010.09941.x
发表时间：
2010-09
期刊：
The British journal of dermatology
影响因子：
--
作者：
Abuabara K;Azfar RS;Shin DB;Neimann AL;Troxel AB;Gelfand JM
通讯作者：
Gelfand JM
影响因子：
39.3
作者：
Mehta, Nehal N.;Azfar, Rahat S.;Gelfand, Joel M.
通讯作者：
Gelfand, Joel M.
影响因子：
10.3
作者：
Brauchli, Y. B.;Jick, S. S.;Meier, C. R.
通讯作者：
Meier, C. R.