Atopic Dermatitis and the Risk of Infection in End-Stage Renal Disease.

Autor: Momin RI; Medical College of Georgia, Augusta University, Augusta, GA 30912, USA., Baer SL; Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.; Charlie Norwood Department, Veterans Affairs Medical Center, Augusta, GA 30904, USA., Waller JL; Medical College of Georgia, Augusta University, Augusta, GA 30912, USA., Young L; School of Nursing at UNC Charlotte, University of North Carolina Charlotte, Charlotte, NC 28223, USA., Tran S; Medical College of Georgia, Augusta University, Augusta, GA 30912, USA., Taskar V; Medical College of Georgia, Augusta University, Augusta, GA 30912, USA., Bollag WB; Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.; Charlie Norwood Department, Veterans Affairs Medical Center, Augusta, GA 30904, USA.
Jazyk: angličtina
Zdroj: Medicina (Kaunas, Lithuania) [Medicina (Kaunas)] 2023 Dec 10; Vol. 59 (12). Date of Electronic Publication: 2023 Dec 10.
DOI: 10.3390/medicina59122145
Abstrakt: Background and Objectives : Atopic dermatitis (AD), also known as eczema, is a common chronic inflammatory skin condition affecting 16.5 million adults in the United States. AD is characterized by an impaired epidermal barrier that can predispose individuals to infection. End-stage renal disease (ESRD) is also commonly complicated by infections due to chronic vascular access and immune-system dysfunction, possibly related to uremia. Multiple studies have reported that renal disease is a common comorbidity in adults with atopic dermatitis. The aim of this study was to determine whether AD is a risk factor for certain infections in patients with ESRD. Materials and Methods : Using the United States Renal Data System, a retrospective cohort analysis was conducted on adult ESRD patients initiating dialysis between 2004 and 2019 to investigate associations between infections and AD in this population. Results : Of 1,526,266 patients, 2290 were identified with AD (0.2%). Infectious outcomes of interest were bacteremia, septicemia, cellulitis, herpes zoster, and conjunctivitis. In all infectious outcomes except for conjunctivitis, patients with the infectious outcomes were more likely to carry a diagnosis of AD. After controlling for demographic and clinical covariates, AD was associated with an increased risk of cellulitis (adjusted relative risk (aRR) = 1.39, 95% confidence interval (CI) = 1.31-1.47) and herpes zoster (aRR = 1.67, CI = 1.44-1.94), but not with bacteremia (aRR = 0.96, CI = 0.89-1.05), septicemia (aRR = 1.02, CI = 0.98-1.08), or conjunctivitis (aRR = 0.97, CI = 0.740-1.34). Conclusions : Overall, after controlling for demographic and clinical covariates and adjusting for person-years-at-risk, AD was associated with an increased risk for some, but not all, infections within the population of patients with ESRD.
Databáze: MEDLINE