TY - JOUR
T1 - Association of psoriasis and stroke in end-stage renal disease patients
AU - Siddiquee, Naomi
AU - Waller, Jennifer L.
AU - Baer, Stephanie L.
AU - Mohammed, Azeem Abdul
AU - Tran, Sarah
AU - Padala, Sandeep Anand
AU - Young, Lufei
AU - Kheda, Mufaddal
AU - Bollag, Wendy B.
N1 - Publisher Copyright:
© 2023
PY - 2023/12
Y1 - 2023/12
N2 - Background: Previous research in the general population suggests that the inflammatory skin disease psoriasis is associated with an increased risk of vascular events, such as stroke. Thus, psoriasis may also represent a risk factor for stroke in end-stage renal disease (ESRD) patients. Methods: We queried the United States Renal Data System for incident dialysis patients between 2004 and 2015. Psoriasis was defined as having at least two international classification of disease (ICD)-9 or ICD-10 diagnosis codes. ICD codes were also used to query the outcome of interest, stroke, as well as other clinical risk factors. Logistic regression was used to examine the association of psoriasis and other risk factors with stroke. Results: Of 966,399 ESRD patients, we identified 89,700 (9.3%) subjects with stroke and 6,286 (0.7%) with psoriasis. Of these psoriasis patients, 796 (0.9%) also had a stroke. Psoriasis was associated with an increased risk of stroke in an unadjusted model [odds ratio (OR)=1.16; 95% confidence interval (CI)=1.08–1.25]. However, after controlling for demographic and clinical risk factors, the final adjusted model showed that psoriasis was not associated with stroke (OR=0.96, CI=0.88–1.04). Congestive heart failure [adjusted OR of 1.79 (CI=1.75–1.83)] was a confounder of the association of psoriasis with stroke. Conclusions: Contrary to prior research in the general population, psoriasis in ESRD patients was not associated with the risk of stroke after controlling for various demographic and clinical parameters. Our finding emphasizes the importance of controlling for a variety of factors in population studies examining associations of diseases and risk factors.
AB - Background: Previous research in the general population suggests that the inflammatory skin disease psoriasis is associated with an increased risk of vascular events, such as stroke. Thus, psoriasis may also represent a risk factor for stroke in end-stage renal disease (ESRD) patients. Methods: We queried the United States Renal Data System for incident dialysis patients between 2004 and 2015. Psoriasis was defined as having at least two international classification of disease (ICD)-9 or ICD-10 diagnosis codes. ICD codes were also used to query the outcome of interest, stroke, as well as other clinical risk factors. Logistic regression was used to examine the association of psoriasis and other risk factors with stroke. Results: Of 966,399 ESRD patients, we identified 89,700 (9.3%) subjects with stroke and 6,286 (0.7%) with psoriasis. Of these psoriasis patients, 796 (0.9%) also had a stroke. Psoriasis was associated with an increased risk of stroke in an unadjusted model [odds ratio (OR)=1.16; 95% confidence interval (CI)=1.08–1.25]. However, after controlling for demographic and clinical risk factors, the final adjusted model showed that psoriasis was not associated with stroke (OR=0.96, CI=0.88–1.04). Congestive heart failure [adjusted OR of 1.79 (CI=1.75–1.83)] was a confounder of the association of psoriasis with stroke. Conclusions: Contrary to prior research in the general population, psoriasis in ESRD patients was not associated with the risk of stroke after controlling for various demographic and clinical parameters. Our finding emphasizes the importance of controlling for a variety of factors in population studies examining associations of diseases and risk factors.
KW - End-stage renal disease
KW - Psoriasis
KW - Stroke
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U2 - 10.1016/j.amjms.2023.09.014
DO - 10.1016/j.amjms.2023.09.014
M3 - Article
C2 - 37716600
AN - SCOPUS:85173124433
SN - 0002-9629
VL - 366
SP - 413
EP - 420
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
IS - 6
ER -