This article is more than 5 years old. Information may no longer be current.

Moderate to severe psoriasis associated with kidney disease risk

Patients with moderate to severe psoriasis had an increased risk for chronic kidney disease, independent of traditional risk factors, according to recent study results.

Joel M. Gelfand, MD, MCSE, associate professor of dermatology and medical director, Dermatology Clinical Studies Unit, University of Pennsylvania Perelman School of Medicine, and colleagues used a United Kingdom electronic medical records database to conduct a cohort study of 136,529 patients with mild psoriasis and 7,354 patients with severe psoriasis, aged 18 to 90 years, matched to 689,702 patients without psoriasis based on age, medical practice and date of visit. Researchers also conducted a nested study of a subgroup of 8,731 patients with psoriasis, aged 25 to 64 years, who were randomly matched with 87,310 patients without psoriasis based on age and medical practice.

 

Joel M. Gelfand

Incident moderate to advanced chronic kidney disease (stage 3 to 5) was the main outcome measure of the cohort study, while baseline prevalence of chronic kidney disease was the primary outcome measure of the nested study.

Incident chronic kidney disease had adjusted hazard ratios of 1.05 (95% CI, 1.02-1.07) for the overall patient group, 0.99 (05% CI, 0.97-1.02) for the patients with mild psoriasis and 1.93 (95% CI, 1.79-2.08) for patients with severe psoriasis. In the severe psoriasis cohort, age had a significant effect (age-specific adjusted HR=3.82; 95% CI, 3.15-4.64 for patients aged 30 years and adjusted HR=2.00; 95% CI, 1.86-2.17 for patients aged 60).

In the nested study, mild, moderate and severe psoriasis patient groups had an adjusted odds ratio for chronic kidney disease of 0.89 (95% CI, 0.72-1.10), 1.36 (95% CI, 1.06-1.74) and 1.58 (95% CI, 1.07-2.34), respectively.

 “Closer monitoring for renal insufficiency, such as routine screening urinalysis for microalbuminuria and serum creatinine and blood urea nitrogen testing, should be considered for patients with psoriasis affecting 3% or more of the body surface area,” the researchers concluded. “Increased screening efforts will allow for earlier detection and intervention to reduce the substantial morbidity and mortality associated with chronic kidney disease.”

Disclosures: See the study for a full list of relevant financial disclosures.