Moderate or severe psoriasis is associated with chronic kidney disease (CKD), according to a study published online in BMJ.

Joy Wan, MD, from the University of Pennsylvania in Philadelphia, and colleagues conducted a population-based cohort study and a nested cross-sectional study to examine the risk of CKD in patients with psoriasis. A total of 136,529 patients with mild psoriasis and 7,354 patients with severe psoriasis were matched to 689,702 unaffected patients in the cohort study. The nested study included 8,731 patients with psoriasis matched to 87,310 patients without psoriasis.

In the cohort study, patients with severe psoriasis were at nearly twofold increased risk for incident CKD in adjusted analyses. Mild psoriasis or psoriasis overall was not associated with a significantly increased risk of incident CKD. In the severe psoriasis group, age was a significant effect modifier. Patients aged 30 years had a 3.8 times increased risk and those aged 60 years had a twofold increased risk. In the nested analysis, moderate and severe psoriasis were associated with a 36% and 58% increased risk of incident CKD, respectively.

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“Closer monitoring for renal insufficiency, such as routine screening urinalysis for microalbuminuria and serum creatinine and blood urea nitrogen testing, should be considered for patients with psoriasis affecting 3% or more of the body surface area,” the authors wrote. “Increased screening efforts will allow for earlier detection and intervention to reduce the substantial morbidity and mortality associated with chronic kidney disease.”