The spectrum of renal abnormalities in patients with psoriasis.
Summary of "The spectrum of renal abnormalities in patients with psoriasis."
OBJECTIVE:
Kidney involvement secondary to psoriasis is a controversial issue. In this study, we evaluated the prevalence of urinary abnormalities in patients with psoriasis. MATERIALS AND
METHODS:
Forty-five psoriasis patients (28 women, 17 men, mean age 44 ± 14 years) and 45 age- and gender-matched control subjects without hypertension or diabetes were enrolled in the study. Psoriasis area and severity index (PASI) was used to assess the severity of psoriasis. Urinalysis by dipstick and microscopic evaluation and 24-h proteinuria and albuminuria were measured in all patients and controls. Pathologic albuminuria was defined as albumin excretion of more than 30 mg/24 h. Renal biopsy was performed in psoriasis patients with urinary abnormalities.
RESULTS:
Patients with psoriasis and controls were not significantly different with respect to the prevalence of abnormal urinalysis (17.7% vs. 13.3%, P = 0.56), mean 24-h proteinuria (145 ± 66 mg/24 h vs. 141 ± 71 mg/24 h, P = 0.54), and albuminuria (21 ± 34 mg/24 h vs. 8 ± 9 mg/24 h, P = 0.31). However, patients with psoriasis had an increased prevalence of pathologic albuminuria compared with controls (24% vs. 2%, P = 0.005). PASI scores in psoriasis patients correlated significantly with 24-h albuminuria (r = 0.458, P = 0.007). Of the eight patients with psoriasis who had urinary abnormalities, four underwent renal biopsy. Two of them had biopsy-proven glomerulonephritis: mesangial proliferative glomerulonephritis in one and IgA nephropathy in the other.
CONCLUSION:
The presence of abnormal urinalysis was not more common in patients with psoriasis than in controls. However, the increased prevalence of pathologic albuminuria and its positive correlation with psoriasis severity may suggest subclinical glomerular dysfunction in these patients.
Affiliation
Department of Nephrology, Kocaeli University School of Medicine, 41380, Kocaeli, Turkey, dervisoglue@yahoo.com.
Journal Details
This article was published in the following journal.
Name: International urology and nephrology
ISSN: 1573-2584
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21505751
- DOI: http://dx.doi.org/10.1007/s11255-011-9966-1
Medical and Biotech [MESH] Definitions
Glomerulonephritis
Inflammation of the renal glomeruli (KIDNEY GLOMERULUS) that can be classified by the type of glomerular injuries including antibody deposition, complement activation, cellular proliferation, and glomerulosclerosis. These structural and functional abnormalities usually lead to HEMATURIA; PROTEINURIA; HYPERTENSION; and RENAL INSUFFICIENCY.
Probenecid
The prototypical uricosuric agent. It inhibits the renal excretion of organic anions and reduces tubular reabsorption of urate. Probenecid has also been used to treat patients with renal impairment, and, because it reduces the renal tubular excretion of other drugs, has been used as an adjunct to antibacterial therapy.
Hepatorenal Syndrome
Functional KIDNEY FAILURE in patients with liver disease, usually LIVER CIRRHOSIS or portal hypertension (HYPERTENSION, PORTAL), and in the absence of intrinsic renal disease or kidney abnormality. It is characterized by intense renal vasculature constriction, reduced renal blood flow, OLIGURIA, and sodium retention.
Hypokalemia
Abnormally low potassium concentration in the blood. It may result from potassium loss by renal secretion or by the gastrointestinal route, as by vomiting or diarrhea. It may be manifested clinically by neuromuscular disorders ranging from weakness to paralysis, by electrocardiographic abnormalities (depression of the T wave and elevation of the U wave), by renal disease, and by gastrointestinal disorders. (Dorland, 27th ed)
Psoriasis
A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis.
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