Details

Autor(en) / Beteiligte

• Nielsen, Valdemar W.
• Yao, Yiqiu
• Holm, Jesper G.
• Jørgensen, Astrid‐Helene R.
• Ring, Hans C.
• Hornum, Mads
• Thomsen, Simon F.

Titel

Decreased glomerular function is associated with disease severity in patients with hidradenitis suppurativa

Ist Teil von

• Health science reports, 2022-03, Vol.5 (2), p.e535-n/a

Ort / Verlag

United States: John Wiley & Sons, Inc

Erscheinungsjahr

2022

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Blood was drawn to determine lipid levels (cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides), inflammatory markers (erythrocyte sedimentation rate [ESR], C-reactive protein, neutrophil–lymphocyte ratio), and creatinine. Table 1 Demographic factors and disease characteristics of patients with hidradenitis suppurativa according to renal function Renal function (eGFR, ml/min per 1.73 m2) Renal function, continuous Decreased (<90) N = 120 (24.5%) Normal (≥90) N = 370 (75.5%) Total N = 490 p value Mean SD B value p value Age, years, median (IQR) 50 (19.5) 35.5 (19) 39 (23) <0.001 −8.05 <0.001 Sex, n (%) 0.027 0.131 Female 87 (72.5) 227 (61.4) 314 (64) 99.4 18.5 Male 33 (27.5) 143 (38.6) 176 (36) 102.1 18.7 Ethnicity 0.026 <0.001 White 107 (89.2) 297 (80.3) 404 (82.4) 98.9 18.3 Non-White 13 (10.8) 73 (19.7) 86 (17.6) 107.2 18.3 Disease severity, n (%) 0.728 0.035 Hurley I 37 (30.8) 125 (33.8) 161 (32.8) 101.9 17.4 Hurley II 64 (53.3) 197 (53.2) 261 (53.3) 100.7 18.4 Hurley III 19 (15.8) 49 (13.2) 68 (13.9) 95.1 21.3 Disease duration, years, median (IQR) 19 (25) 10 (15) 11 (17) <0.001 −0.483 <0.001 HSS, median (IQR) 12.5 (15.7) 12 (17) 12 (16) 0.836 −0.059 0.227 Total boils, median (IQR) 1 (3) 1 (3) 1 (3) 0.198 0.534 0.027 Boils last month, mean (IQR) 1 (3) 2 (3) 2 (3) 0.228 0.434 0.106 BMI, median (IQR), kg/m2 28.7 (7.3) 27.8 (9.8) 28.07 (9.2) 0.766 −0.022 0.858 Smoking, n (%) 0.327 0.27 Yes 93 (77.5) 301 (81.6) 394 (80.6) 99.9 18.7 No 27 (22.5) 68 (18.4) 95 (19.4) 102.3 18.1 Comorbidities, n (%) Dyslipidemia 18 (15) 25 (6.8) 43 (8.8) 0.006 88.6 20.8 <0.001 No 102 (85) 345 (93.2) 447 101.5 18 Hypertension 76 (63.3) 181 (48.9) 257 (52.3) 0.006 97.2 18.9 <0.001 No 44 (36.7) 189 (51.1) 233 103.8 17.6 Diabetes 14 (11.7) 28 (7.6) 42 (8.6) 0.163 92.7 25.8 0.005 No 106 (88.3) 342 (92.4) 448 101.1 17.6 Mean arterial pressure, mmHg (SD) 104.8 (13.1) 101.4 (12.6) 102.2 (12.8) 0.011 −0.197 0.003 Lipid levels, median (IQR), mmol/L Total cholesterol 4.8 (1.3) 4.5 (1.3) 4.6 (1.2) 0.102 −0.117 0.59 HDL-C 1.3 (0.5) 1.3 (0.6) 1.3 (0.5) 0.047 −4.474 0.012 LDL-C 2.8 (1.3) 2.4 (1.2) 2.5 (1.2) 0.676 −0.928 0.356 Triglycerides 1.5 (1) 1.2 (1.1) 1.3 (1.1) 0.003 −2.69 0.001 Inflammatory markers, median (IQR) ESR, mm/h 11 (16) 10 (13) 10 (13) 0.118 −0.167 <0.001 CRP, mg/L 3 (7) 3 (7) 3 (7) 0.89 −0.056 0.221 NLR 2.4 (1.5) 2.2 (1.3) 2.23 (1.3) 0.237 −0.809 0.254 Note: Boils are a total number of boils at clinical examination. eGFR was estimated from creatinine levels at clinical examination and calculated using the age and sex-specific CKD-EPI equation. Abbreviations: BMI, body mass index; CKD, chronic kidney disease; CRP, C-reactive protein; eGFR, estimated glomerular filtration rate; ESR, erythrocyte sedimentation rate; HDL, high-density lipoprotein; HSS, hidradenitis suppurativa score; IQR, interquartile range; LDL, low-density lipoprotein; NLR, neutrophils–lymphocytes ratio. DISCUSSION Patients with HS have chronic systemic inflammation, characterized by persistent, elevated levels of circulating inflammation markers. 6 Abnormal cytokine expression of interleukin-1 (IL-1) has been demonstrated in both lesional and uninvolved skin, supporting the increased systemic inflammatory load in patients with HS. 7 The role of inflammation in CKD pathogenesis and progression has been recognized for several years, expressed as upregulated monocyte release of IL-1 causing vascular dysfunction in patients with CKD. 8 Our study found a significant decrease in eGFR in more severe diseases, possibly due to the long-standing inflammatory burden in patients presenting with Hurley stage III, supported by the inverse relationship between elevated ESR and decreased eGFR.