{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T01:13:19Z","timestamp":1783905199843,"version":"3.55.0"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["IK6 BX005691"],"award-info":[{"award-number":["IK6 BX005691"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine"],"abstract":"<jats:p>Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition associated with disrupted skin integrity, while end-stage renal disease (ESRD) is marked by immune dysfunction and a heightened risk for systemic infections. The intersection of these conditions may increase susceptibility to bloodstream infections, yet this relationship remains underexplored. This study aimed to assess whether HS increases the risk of bacteremia, septicemia, and candidemia in patients with ESRD. A retrospective cohort study was conducted using the United States Renal Data System (USRDS). Adults aged 18\u2013100 who initiated hemodialysis between 2005 and 2019 were included. A diagnosis of HS was determined via International Classification of Diseases (ICD)-9 and ICD-10 codes. Infectious outcomes, also assessed using ICD codes, were measured following HS diagnosis. Multivariable logistic regression models were used to estimate the relative risk (RR) of infection. Among 1,397,827 ESRD patients, 0.1% had HS, a prevalence that aligns with previously reported rates in the general U.S. population, suggesting that most HS cases were likely captured. After adjustment, HS was not significantly associated with diagnoses of bacteremia (RR\u2009=\u20090.98, 95% CI: 0.87\u20131.09) or candidemia (RR\u2009=\u20091.25, 95% CI: 0.86\u20131.83). However, HS was independently associated with a significantly increased risk of an ICD diagnosis of septicemia (RR\u2009=\u20093.24, 95% CI: 2.41\u20134.34). Although the prevalence of a bacteremia or candidemia diagnosis was not increased in ESRD patients with HS, these patients were more likely to be labeled as having \u201csepticemia\u201d per ICD codes. This highlights the importance of heightened clinical awareness and the potential need for tailored infection-prevention strategies in this subpopulation.<\/jats:p>","DOI":"10.1177\/10815589261462559","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T06:04:01Z","timestamp":1781503441000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The association of hidradenitis suppurativa with increased risk of systemic infections in end-stage renal disease"],"prefix":"10.1177","author":[{"given":"Adaora","family":"Ntukogu","sequence":"first","affiliation":[{"name":"Department of Medicine, Medical College of Georgia at Augusta University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6646-4590","authenticated-orcid":false,"given":"Fabiha","family":"Anwar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Medical College of Georgia at Augusta University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rushan","family":"Momin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Medical College of Georgia at Augusta University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4066-4541","authenticated-orcid":false,"given":"Jennifer L.","family":"Waller","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, Medical College of Georgia at Augusta University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Baer","sequence":"additional","affiliation":[{"name":"VA Augusta Healthcare System, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3146-162X","authenticated-orcid":false,"given":"Wendy B.","family":"Bollag","sequence":"additional","affiliation":[{"name":"Department of Medicine, Medical College of Georgia at Augusta University, USA"},{"name":"VA Augusta Healthcare System, GA, USA"},{"name":"Department of Physiology, Medical College of Georgia at Augusta University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Nguyen TV Damiani G Orenstein LAV et al. Hidradenitis suppurativa: an update on epidemiology phenotypes diagnosis pathogenesis comorbidities and quality of life. J Eur Acad Dermatol Venereol 2021; 35(1): 50\u201361. https:\/\/doi.org\/10.1111\/jdv.16677","DOI":"10.1111\/jdv.16677"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","unstructured":"Van Straalen KR Prens EP Gudjonsson JE. Insights into hidradenitis suppurativa. J Allergy Clin Immunol 2022; 149(4): 1150\u20131161. https:\/\/doi.org\/10.1016\/j.jaci.2022.02.003","DOI":"10.1016\/j.jaci.2022.02.003"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","unstructured":"Preda-Naumescu A Ahmed HN Mayo TT et al. Hidradenitis suppurativa: pathogenesis clinical presentation epidemiology and comorbid associations. Int J Dermatol 2021; 60(11): e449\u2013e458. https:\/\/doi.org\/10.1111\/ijd.15579","DOI":"10.1111\/ijd.15579"},{"key":"e_1_3_2_5_2","volume-title":"End-stage renal disease","author":"Hashmi MF","year":"2025","unstructured":"Hashmi MF, Benjamin O, Lappin SL. End-stage renal disease. StatPearls, 2025."},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","unstructured":"Kato S Chmielewski M Honda H et al. Aspects of immune dysfunction in end-stage renal disease. Clin J Am Soc Nephrol 2008; 3(5): 1526\u20131533. https:\/\/doi.org\/10.2215\/CJN.00950208","DOI":"10.2215\/CJN.00950208"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","unstructured":"Schwade MJ Tien L Waller JL et al Treatment of psoriasis in end-stage renal disease patients is associated with decreased mortality: a retrospective cohort study. Am J Med Sci 2021; 362(1): 24\u201333. https:\/\/doi.org\/10.1016\/j.amjms.2021.03.009","DOI":"10.1016\/j.amjms.2021.03.009"},{"key":"e_1_3_2_8_2","doi-asserted-by":"crossref","unstructured":"Curtis MM Way SS. Interleukin-17 in host defence against bacterial mycobacterial and fungal pathogens. 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US Renal Data System 2021 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis 2022; 79(4Suppl 1): A8\u2013A12. https:\/\/doi.org\/10.1053\/j.ajkd.2022.02.001","DOI":"10.1053\/j.ajkd.2022.02.001"},{"key":"e_1_3_2_12_2","doi-asserted-by":"crossref","unstructured":"Toth E Waller JL Bollag WB et al. Non-tuberculous mycobacterial infections in patients with end-stage renal disease: prevalence risk factors and mortality. J Investig Med 2023; 71(7): 707\u2013715. https:\/\/doi.org\/10.1136\/jim-2022-002462","DOI":"10.1136\/jim-2022-002462"},{"key":"e_1_3_2_13_2","doi-asserted-by":"crossref","unstructured":"Pyrgos V Ratanavanich K Donegan N et al. Candida bloodstream infections in hemodialysis recipients. Med Mycol 2009; 47(5): 463\u2013467. https:\/\/doi.org\/10.1080\/13693780802369332","DOI":"10.1080\/13693780802369332"},{"key":"e_1_3_2_14_2","doi-asserted-by":"crossref","unstructured":"Cornely OA Sprute R Bassetti M et al. Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM. Lancet Infect Dis 2025; 25(5): e280\u2013e293. https:\/\/doi.org\/10.1016\/S1473-3099(25)00657-7","DOI":"10.1016\/S1473-3099(25)00657-7"},{"key":"e_1_3_2_15_2","doi-asserted-by":"crossref","unstructured":"Esmaili N Mortazavi H Noormohammadpour P et al. Pemphigus vulgaris and infections: a retrospective study on 155 patients. Autoimmune Dis 2013; 2013: 834295. https:\/\/doi.org\/10.1155\/2013\/834295","DOI":"10.1155\/2013\/834295"},{"key":"e_1_3_2_16_2","doi-asserted-by":"crossref","unstructured":"Momin RI Baer SL Waller JL et al. Atopic dermatitis and the risk of infection in end-stage renal disease. Medicina (Kaunas) 2023; 59(12): 2145. https:\/\/doi.org\/10.3390\/medicina59122145","DOI":"10.3390\/medicina59122145"},{"key":"e_1_3_2_17_2","doi-asserted-by":"crossref","unstructured":"Gau SY Yang CY Li YF et al. Renal dysfunction in people with hidradenitis suppurativa: a multi-center propensity-score-matched cohort study. Int J Med Sci 2025; 22(3): 558\u2013564. https:\/\/doi.org\/10.7150\/ijms.102434","DOI":"10.7150\/ijms.102434"},{"key":"e_1_3_2_18_2","doi-asserted-by":"crossref","unstructured":"Abu Rached N Gambichler T Ocker L et al. Screening for diabetes mellitus in patients with hidradenitis suppurativa-a monocentric study in Germany. Int J Mol Sci 2023; 24(7): 6596. https:\/\/doi.org\/10.3390\/ijms24076596","DOI":"10.3390\/ijms24076596"},{"key":"e_1_3_2_19_2","doi-asserted-by":"crossref","unstructured":"Rhee JJ Zheng Y Liu S et al. Glycemic control and infections among us hemodialysis patients with diabetes mellitus. Kidney Int Rep 2020; 5(7): 1014\u20131025. https:\/\/doi.org\/10.1016\/j.ekir.2020.04.020","DOI":"10.1016\/j.ekir.2020.04.020"},{"key":"e_1_3_2_20_2","doi-asserted-by":"crossref","unstructured":"Abu Rached N Dietrich JW Ocker L et al. 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