Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.
Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.
Br J Dermatol. 2015 Jul;173(1):146-54. doi: 10.1111/bjd.13599. Epub 2015 May 12.
Few studies have examined the association between psoriasis and glomerulonephritis (GN) as well as chronic kidney disease (CKD).
To determine the risk of CKD in patients with psoriasis and evaluate the impact of the severity of psoriasis, comorbidities and concomitant drugs on the risk of GN and CKD in patients with psoriasis.
We identified 4344 patients with psoriasis for the study cohort and randomly selected 13,032 subjects as a control cohort. Each subject was individually followed for up for 5 years to identify those who subsequently developed GN and CKD.
After adjustment for traditional CKD risk factors, psoriasis was found to be independently associated with an increased risk of CKD during the follow-up period [hazard ratio (HR) 1.28; 95% confidence interval (CI) 1.14-1.44]. The increased incidence of GN in patients with psoriasis (HR 1.50, 95% CI 1.24-1.81) may contribute to the positive association between psoriasis and CKD. Patients with mild and severe psoriasis had an increased risk of CKD and GN compared with the control cohort; the risk increased with severity. Patients with psoriasis and arthritis exhibited a higher risk of CKD than patients without arthritis (HR 1.62 vs. 1.26). Among drugs, nonsteroidal anti-inflammatory drugs (NSAIDs) have the strongest association with CKD in patients with psoriasis (adjusted odds ratio 1.69, 95% CI 1.14-2.49).
Psoriasis was associated with a higher risk of developing CKD and GN. High severity, psoriatic arthritis involvement and concomitant NSAIDs use further increased the risk of CKD in patients with psoriasis.
很少有研究探讨银屑病与肾小球肾炎（GN）和慢性肾脏病（CKD）之间的关系。
确定银屑病患者发生 CKD 的风险，并评估银屑病严重程度、合并症和伴随药物对银屑病患者发生 GN 和 CKD 的风险的影响。
我们在研究队列中确定了 4344 名银屑病患者，并随机选择了 13032 名受试者作为对照队列。对每位患者进行单独随访 5 年，以确定随后发生 GN 和 CKD 的患者。
在调整传统 CKD 危险因素后，发现银屑病与随访期间 CKD 风险增加独立相关[风险比（HR）1.28；95%置信区间（CI）1.14-1.44]。银屑病患者 GN 发生率增加（HR 1.50，95%CI 1.24-1.81）可能导致银屑病与 CKD 之间存在正相关关系。与对照组相比，轻度和重度银屑病患者发生 CKD 和 GN 的风险增加；风险随严重程度增加而增加。患有银屑病和关节炎的患者发生 CKD 的风险高于没有关节炎的患者（HR 1.62 比 1.26）。在药物中，非甾体抗炎药（NSAIDs）与银屑病患者 CKD 的相关性最强（调整后优势比 1.69，95%CI 1.14-2.49）。
银屑病与 CKD 和 GN 的发生风险增加相关。高严重程度、银屑病关节炎受累和伴随 NSAIDs 使用进一步增加了银屑病患者发生 CKD 的风险。
