Category Archives: Psoriasis

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TUESDAY, Oct. 15 (HealthDay News) -- People with moderate to severe psoriasis are at increased risk for chronic kidney disease and need to be closely monitored for kidney problems, a large new study suggests.

Researchers in Philadelphia analyzed data from nearly 144,000 people, aged 19 to 90, with psoriasis, and a comparison (control) group of nearly 690,000 adults without the condition.

During seven years of follow-up, people with psoriasis were more likely to develop chronic kidney disease than those in the control group. Those with severe psoriasis had a nearly two-fold higher risk of developing kidney disease and a more than fourfold higher risk of developing kidney failure requiring dialysis, according to a journal news release

Further investigation that focused on the amount of skin area affected by psoriasis showed that people with moderate to severe psoriasis were at greater risk of developing chronic kidney disease. People with moderate psoriasis have 3 percent to 10 percent of skin area affected, while those with severe psoriasis have more than 10 percent of skin area affected.

Psoriasis is a chronic condition involving scaly skin patches that can lead to itching, cracking and bleeding. As many as 7.5 million Americans have the autoimmune condition, according to the National Psoriasis Foundation.

Moderate and severe psoriasis affect more than 20 percent of patients worldwide, according to the study, which appears Oct. 15 in the journal BMJ.

Although the study found an association between having psoriasis and a higher risk of kidney problems, it did not establish a cause-and-effect relationship.

The researchers also found that the risk of chronic kidney disease linked to psoriasis increases with age. In patients aged 40 to 50 with severe disease, psoriasis accounted for one extra case of chronic kidney disease per 134 patients yearly. In those aged 50 to 60, it accounted for one extra case yearly per 62 patients.

Further research is needed to confirm the study findings, determine how psoriasis can cause kidney disease and examine how psoriasis treatment affects the risk for kidney disease, the researchers concluded.

-- Robert Preidt

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Study Sees Link Between Psoriasis, Kidney Problems

PHILADELPHIA The latest look at connections between psoriasis and other serious medical conditions revealed for the first time that people with more serious cases of psoriasis are at twice the risk of developing chronic kidney disease and four times the risk of developing end stage renal disease requiring dialysis. Researchers from the Perelman School of Medicine at the University of Pennsylvania found that patients with mild forms of the disease are not at an increased risk, but those with psoriasis on more than 3 percent of their body are at greater risk. Psoriasis increases this risk independently, regardless of other risk factors for kidney disease, such as diabetes, hypertension or use of NSAIDS.

"With this knowledge, physicians can change how they practice: they can proactively screen moderate to severe psoriasis patients for kidney disease with simple blood and urine tests and carefully consider prescribing any medications that could be toxic to the kidneys," said senior study author, Joel M. Gelfand, MD, MSCE, associate professor of Dermatology and Epidemiology.

The research team analyzed a database including 136,529 patients with mild psoriasis and 7,354 patients with severe psoriasis and matched them to 689,702 unaffected patients. Also, in a nested-analysis of data from the incident health outcomes and psoriasis events (iHOPE) study, they evaluated the prevalence of chronic kidney disease in 9,000 psoriasis patients being followed prospectively through the electronic medical record in whom their general practitioners provided additional information about psoriasis such as body surface area affected to Dr. Gelfand and his team. They found associations with moderate to advanced kidney disease in patients with both moderate and severe psoriasis, which are estimated to affect over 20 percent of psoriasis patients worldwide.

The relative risk appeared to be highest among younger patients with severe psoriasis. The team looked and found that the association between severe psoriasis and renal insufficiency was not driven by joint disease or its associated use of nephrotoxic drugs.

"While the mechanisms related to renal injury in psoriasis remain unclear, this study is the first large scale, well controlled investigation evaluating kidney disease and psoriasis," said Gelfand. "These findings will likely change clinical practice recommendations."

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Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of theRaymond and Ruth Perelman School of Medicine at the University of Pennsylvania(founded in 1765 as the nation's first medical school) and theUniversity of Pennsylvania Health System, which together form a $4.3 billion enterprise.

The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 16 years, according toU.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $398 million awarded in the 2012 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized as one of the nation's top "Honor Roll" hospitals byU.S. News & World Report; Penn Presbyterian Medical Center; Chester County Hospital; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2012, Penn Medicine provided$827million to benefit our community.

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Severe Psoriasis Doubles Risk of Kidney Disease, Penn Medicine Study Shows

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Psoriasis. Anatomy of the skin
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