Patients with hidradenitis suppurativa have a significantly increased risk of poor renal outcomes compared with people with acne, including end-stage renal disease and a need for dialysis, according to a large-scale study.

Writing in a brief report, doctors from LSU Health in New Orleans said while hidradenitis suppurativa had been linked to many systemic comorbidities that contributed to increased mortality, investigations into a potential link between the chronic inflammatory skin disorder and renal dysfunction were limited.

Their retrospective study involved 256,454 adults diagnosed with hidradenitis suppurativa (mean age 36, 74% female) who were propensity score matched 1:1 to controls with acne based on comorbidities and demographic information.

Findings published in the Journal of the American Academy of Dermatology [link here] demonstrated that patients with hidradenitis suppurativa had significantly higher incidence of all renal outcomes compared to individuals with acne.

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Incident chronic kidney disease occurred in 3.3% of the hidradenitis suppurativa group versus 3.1% of the control group (RR 1.09; HR 1.26), while acute kidney injury occurred in 4.3% and 3.2% of the groups respectively (RR 1.32; HR 1.53).

Notably, the researchers pointed out that the hidradenitis suppurativa group had a higher incidence of end-stage renal disease compared with controls, which occurred in 0.6% versus 0.4% of the groups respectively (RR 1.40; HR 1.60) and a higher incidence of dialysis, 0.7% versus 0.4% respectively  (RR 1.61%; HR 1.84).

“This study corroborates previous research demonstrating an increased renal risk in hidradenitis suppurativa, provides novel large-scale evidence that, compared to acne, hidradenitis suppurativa is associated with a higher incidence of end-stage renal disease and dialysis treatment in adults over a median of approximately three years post-diagnosis,” the researchers said.

“While these results do not currently warrant changes to screening recommendations for hidradenitis suppurativa patients, we suggest that our results be viewed as exploratory.

“Further investigations are required to better understand the etiology of this association, evaluate the potential benefit of screening hidradenitis suppurativa patients for kidney disease, and assess the impact of multidisciplinary hidradenitis suppurativa management on renal outcomes.”