Kaur Ishmeet, Gandhi Vijay, Raizada Alpana, Bhattacharya Sambit Nath, Tripathi Ashok K, Jakhar Deepak
Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India.
Department of Medicine, University College of Medical Sciences and GTB Hospital, Delhi, India.
Indian Dermatol Online J. 2020 Jan 13;11(1):29-34. doi: 10.4103/idoj.IDOJ_84_19. eCollection 2020 Jan-Feb.
Psoriasis is a multisystem disorder associated with various systemic diseases such as cardiovascular diseases, diabetes mellitus and metabolic syndrome. Renal involvement in patients with psoriasis is sparsely studied and its association is still unclear.
The aim of this article was to study causal attributable renal involvement in patients with psoriasis and factors affecting the same.
Fifty patients with documented psoriasis were recruited after excluding any secondary causes of renal disease. They were subjected to routine investigations along with hs-CRP and specific investigations for kidney function including urine albumin creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR). The eGFR and ACR of the patients were compared with 50 age- and sex-matched controls. Association with any disease-related factors such as severity and duration were assessed. Renal biopsy was planned in patient with ACR >500 mg/g creatinine.
The mean eGFR (IQR) (ml/min/1.73 m) of the case group was found to be 80.00 (71.00-95.75) and in the control group was 88.00 (75.25-99.00). This difference was not significant ( = 0.206). However, in the age group of > 30 years, the eGFR of disease group (78.50 ± 17.94) was significantly lower than that in the control group (88.96 ± 17.01, = 0.023).The mean urine ACR (mg/g) in the disease group was found to be 13.359 ± 26.01 while that in the control group was found to be 5.66 (3.40-8.08), and the difference was not found to be clinically significant. Four patients with psoriasis had microalbuminuria as opposed to none of the controls.
Subclinical albuminuria was found in 8 per cent of patients with psoriasis. Glomerular dysfunction with statistically significant reduction in eGFR was seen in psoriasis in age group of more than 30 years and those who had a long-standing disease. The renal involvement had positive correlation with hs-CRP indicating the role of inflammatory milieu. Further large-scale cohort studies would help assess this aspect in further details.
Sample size was small. Large-scale studies would be required to further substantiate these observations.
银屑病是一种多系统疾病，与心血管疾病、糖尿病和代谢综合征等多种全身性疾病相关。银屑病患者的肾脏受累情况研究较少，其关联性仍不明确。
本文旨在研究银屑病患者中因果归因的肾脏受累情况及其影响因素。
排除任何肾脏疾病的继发原因后，招募了50例有银屑病记录的患者。他们接受了包括高敏C反应蛋白（hs-CRP）在内的常规检查以及肾功能的特定检查，包括尿白蛋白肌酐比值（ACR）和估计肾小球滤过率（eGFR）。将患者的eGFR和ACR与50名年龄和性别匹配的对照组进行比较。评估与任何疾病相关因素如严重程度和病程的关联性。计划对ACR>500mg/g肌酐的患者进行肾活检。
病例组的平均eGFR（四分位间距）（ml/min/1.73m²）为80.00（71.00 - 95.75），对照组为88.00（75.25 - 99.00）。这种差异不显著（P = 0.206）。然而，在年龄大于30岁的组中，疾病组的eGFR（78.50±17.94）显著低于对照组（88.96±17.01，P = 0.023）。疾病组的平均尿ACR（mg/g）为13.359±26.01，而对照组为5.66（3.40 - 8.08），差异未发现具有临床显著性。4例银屑病患者有微量白蛋白尿，而对照组无。
8%的银屑病患者存在亚临床白蛋白尿。在年龄大于30岁以及患有长期疾病的银屑病患者中，观察到肾小球功能障碍且eGFR有统计学显著降低。肾脏受累与hs-CRP呈正相关，表明炎症环境的作用。进一步的大规模队列研究将有助于更详细地评估这一方面。
样本量小。需要大规模研究来进一步证实这些观察结果。
