Abstract
Psoriasis, a chronic inflammatory dermatosis, has been associated with chronic kidney disease or end-stage renal disease. However, the association of the changes or amount of proteinuria with psoriasis development has not been evaluated. Using the Korean National Health Screening database, we assessed psoriasis development until 2018 in 6,576,851 Koreans who underwent health examinations in 2009 and 2011. Psoriasis was defined using the International Classification of Diseases, 10th revision (ICD-10) code L40. The risk of psoriasis was evaluated according to change in proteinuria (never [Neg (no proteinuria)/Neg], new [Neg/Pos (proteinuria present)], past [Pos/Neg] and persistent [Pos/Pos] proteinuria) and the proteinuria amount. During a median 7.23-year follow-up, 162,468 (2.47%) individuals developed psoriasis. After adjustments, the hazard ratio (HR) for psoriasis was higher in the persistent proteinuria group (1.32 [1.24–1.40]) than in the never proteinuria group. The past proteinuria group showed better renal outcome (1.03 [1.00–1.07]) than the new (1.05 [1.01–1.07]) and never proteinuria (reference, 1.00) groups did. The amount of random urine proteinuria was associated with increased HR for psoriasis. Subgroup analyses for age, sex, estimated glomerular filtration rate (eGFR), hypertension and diabetes showed that the persistent proteinuria group had a higher risk of psoriasis than the never proteinuria group, especially at eGFR < 60 mL/min/1.73 m2. Persistent proteinuria is associated with psoriasis risk, and the proteinuria amount significantly affects psoriasis development.
Highlights
Psoriasis is a chronic inflammatory skin disease that affects 1–3% of the general population [1,2]
≥ 90 cm in men and ≥ 85 cm in women) were higher in the incident psoriasis group than in the non-psoriasis group. Comorbidities such as diabetes mellitus (DM), hypertension and dyslipidemia were more prevalent in the psoriasis group than in the non-psoriasis group. estimated glomerular filtration rate (eGFR) was lower, whereas Blood pressure (BP), total cholesterol and glucose levels were higher in the psoriasis group than in the non-psoriasis group (Table 1)
In this large population-based study, we found that proteinuria was associated with the risk of psoriasis and the new proteinuria group had a higher risk than the past proteinuria group
Summary
Psoriasis is a chronic inflammatory skin disease that affects 1–3% of the general population [1,2]. The prevalence rates vary between countries and ethnic groups. It is more common in Caucasians and in countries with higher latitudes and affects men and women [3]. The prevalence of psoriasis has been showing an increasing trend in certain countries [2,4,5]. The etiology of this disorder is not known; several risk factors have been identified, including smoking, obesity and alcohol abuse [6,7,8,9]. Studies have demonstrated that Th17 lymphocytes can induce inflammation in the kidneys by mediating tubular epithelial cells, mesangial cells and macrophages [11]
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