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银屑病的肾脏受累:一项来自中国的病例对照研究。

Kidney involvement in psoriasis: a case-control study from China.

作者信息

Ren Fang, Zhang Min, Hao Liying, Sang Hong

机构信息

Southern Medical University, Guangzhou, China.

Department of Dermatology, Jinling Hospital, 305 Zhongshan East Road, Nanjing, 210003, Jiangsu, China.

出版信息

Int Urol Nephrol. 2017 Nov;49(11):1999-2003. doi: 10.1007/s11255-017-1692-x. Epub 2017 Sep 22.

Abstract

PURPOSE

Kidney involvement secondary to psoriasis is still a controversial issue. In this study, we aimed to evaluate the prevalence of urinary abnormalities in psoriasis patients and to find out whether the abnormality is related to the severity of psoriasis.

METHODS

Ninety-seven psoriasis patients (62 females, 35 males, mean age 35.74 ± 13.45 years) and ninety-six age- and gender-matched control subjects (58 males, 38 females, mean age 35.82 ± 13.48 years) without hypertension or diabetes were enrolled in this study. Psoriasis area and severity index (PASI) was used to assess the severity of psoriasis. Twenty-four-hour proteinuria, albuminuria, RBP, and NAG were measured in all patients and controls. Pathologic proteinuria was defined as the total protein excretion of more than 0.4 g/24 h, as measured by the turbidimetric assay. Pathologic albuminuria was defined as albumin excretion of more than 17 mg/24 h. Pathologic NAG and RBP were defined as the excretion of more than 16.5 u/g cr and 0.5 mg/L, respectively.

RESULTS

Increased 24-h microalbuminuria (11.53 ± 7.29 vs. 9.79 ± 3.72, P = 0.039) and 24-h proteinuria (0.24 ± 0.21 vs. 0.18 ± 0.09, P = 0.002) were found in patients with psoriasis compared with controls. Patients with psoriasis had an increased prevalence of pathological albuminuria (15.46 vs. 5.21%, P = 0.019), NAG (10.31 vs. 3.13%, P = 0.046), and RBP (9.28 vs. 2.08%, P = 0.031) compared with controls. PASI scores in patients with psoriasis correlated positively with 24-h albuminuria (χ  = 10.75, P = 0.005).

CONCLUSIONS

The prevalence of abnormal urinalysis was more common in patients with psoriasis than in controls. The positive correlation between the prevalence of pathological albuminuria and psoriasis severity may indicate a subclinical renal dysfunction in patients with psoriasis.

摘要

目的

银屑病继发肾脏受累仍是一个有争议的问题。在本研究中,我们旨在评估银屑病患者尿液异常的患病率,并探究该异常是否与银屑病的严重程度相关。

方法

本研究纳入了97例银屑病患者(62例女性,35例男性,平均年龄35.74±13.45岁)和96例年龄及性别匹配的对照者(58例男性,38例女性,平均年龄35.82±13.48岁),这些对照者无高血压或糖尿病。采用银屑病面积和严重程度指数(PASI)评估银屑病的严重程度。对所有患者和对照者测量24小时蛋白尿、白蛋白尿、视黄醇结合蛋白(RBP)和N-乙酰-β-D-氨基葡萄糖苷酶(NAG)。病理性蛋白尿定义为通过比浊法测得的24小时总蛋白排泄量超过0.4g/24小时。病理性白蛋白尿定义为白蛋白排泄量超过17mg/24小时。病理性NAG和RBP分别定义为排泄量超过16.5u/g肌酐和0.5mg/L。

结果

与对照组相比,银屑病患者的24小时微量白蛋白尿(11.53±7.29 vs. 9.79±3.72,P = 0.039)和24小时蛋白尿(0.24±0.21 vs. 0.18±0.09,P = 0.002)增加。与对照组相比,银屑病患者病理性白蛋白尿(15.46 vs. 5.21%,P = 0.019)、NAG(10.31 vs. 3.13%,P = 0.046)和RBP(9.28 vs. 2.08%,P = 0.031)的患病率增加。银屑病患者的PASI评分与24小时白蛋白尿呈正相关(χ = 10.75,P = 0.

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