Chronic Kidney Disease Severity May Contribute to Development of Prurigo Nodularis

Reduced estimated glomerular filtration rate and the presence of proteinuria were independent risk factors for the development of prurigo nodularis in patients with chronic kidney disease, according to a nationwide cohort study published in Acta Dermato-Venereologica.

“With differential impact of chronic kidney disease severity on the risk of prurigo nodularis, preservation of renal function would potentially translate into lower risk of prurigo nodularis,” researchers wrote.

Although prurigo nodularis, a chronic skin condition characterized by itchy nodules on the limbs and trunk, has been linked with dialysis, this study focused on the impact of nondialysis chronic kidney disease on development of the condition. The analysis included 17.3 million adults in Korea who received a standardized health check-up between 2009 and 2010 and who did not have a diagnosis of prurigo nodularis.

Over a median 10 years of follow-up, 58,599 people developed the skin condition. The incidence rate of prurigo nodularis was 3.59 per 10,000 person-years.

A reduced estimated glomerular filtration rate, calculated from serum creatinine, was the strongest risk factor for prurigo nodularis. The study also identified the presence of proteinuria as another independent risk factor.

Compared with a rate of 90 or higher, an estimated glomerular filtration rate between 15 and 29 was associated with increased risk, as was end-stage renal disease. Proteinuria increased both of those risks, and also caused the risk associated with an estimated glomerular filtration rate between 30 and 59 to become significant, according to the study.

“According to subgroup analyses, the estimated glomerular filtration rate-associated risk of prurigo nodularis was heightened in those with a fasting blood sugar level ≥126 mg/dl, and in smokers,” researchers wrote, “which indicates that chronic kidney disease patients with diabetes mellitus or a history of smoking are the most vulnerable to developing prurigo nodularis.”

Reference:
Kim HS, Kim HJ, Ahn HS. Impact of chronic kidney disease severity on the risk of prurigo nodularis: a population-based cohort study. Acta Derm Venereol. 2022;102:adv00781. doi: 10.2340/actadv.v102.2227