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

oleh: Rushan I. Momin, Stephanie L. Baer, Jennifer L. Waller, Lufei Young, Sarah Tran, Varsha Taskar, Wendy B. Bollag

Format: Article
Diterbitkan: MDPI AG 2023-12-01

Deskripsi

<i>Background and Objectives</i>: 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. <i>Materials and Methods</i>: 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. <i>Results</i>: 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). <i>Conclusions</i>: 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.