Clinical Correlation Analysis Of Psoriasis And Glomerular Filtration Rate In Adults

Objective:To analyze the clinical characteristics of the low glomerular filtration rate(eGFR)group and the normal or high group of adult patients with psoriasis,observe and analyze the related factors of eGFR reduction in psoriasis patients,and provide some clues for the diagnosis and treatment of kidney damage in psoriasis.Methods:A retrospective study was adopted to collect the inpatient data of adult psoriasis patients hospitalized in the Department of Dermatology,The Second Affiliated Hospital of Kunming Medical University from January 2014 to September2021,and the patients were divided into low filtration group according to eGFR value[eGFR<90mL/(min·1.73m~2)]and normal or high filtration group[eGFR≥90mL/(min·1.73m~2)],the basic situation,onset,clinical characteristic,laboratory tests,treatment and outcome data of the two groups were collected,and the differences between the two groups were compared using statistical methods(t-test,chi-square test,rank sum test,Fisher exact probability and logistic regression analysis).Results:1.The study included 327 adult patients with psoriasis,aged 18 to 90 years old(mean age 46.37±14.74),214 males(65.4%)and 113 females(34.6%),with a male-to-female ratio of 1.89 to 1.There were 86 cases(26.3%)in the eGFR low filtration group and 241 cases(73.7%)in the normal or high filtration group,with a low filtration group-to-normal or high filtration group ratio of 1 to 2.8.2.The age of admission and the course of disease in the low filtration group were higher than those in the normal or high filtration group(P<0.05).There was no significant difference in sex,nationality,type of psoriasis,smoking history,drinking history and family history of psoriasis between the two groups(P>0.05).3.The proportion of the first lesion in the scalp in the low filtration group was lower than that in the normal or high filtration group,and the proportion of joint pain in the low filtration group was higher than that in the normal or high filtration group(P<0.05).There was no significant difference in skin symptoms,location and characteristics of skin lesions between the two groups(P>0.05).4.Compared with normal or high filtration group,the levels of serum protein,creatine kinase,urea,creatinine,uric acid,sodium,d-dimer,interleukin-6,positive urinary occult blood and positive urine protein were higher in low filtration group,while red blood cells and albumin globulin ratio were lower in low filtration group.There was no significant difference in the composition of other laboratory indexes between the two groups(P>0.05).There was no significant difference in previous treatment,main medication,length of stay,cost and outcome between the two groups(P>0.05).5.Multivariate Logistic regression analysis showed that long course of psoriasis,high serum uric acid level and positive urine protein were significantly associated with an increased risk of eGFR reduction.On the contrary,the first lesion appeared on the scalp and the high level of red blood cells were significantly associated with an reduced risk of eGFR reduction.Conclusions:The longer the course of psoriasis,the greater the risk of reduced glomerular filtration rate,while the lower the risk of reduced glomerular filtration rate of the first lesion in the scalp.Joint pain has certain reference value for reducing glomerular filtration rate.In clinical work,it is necessary to pay attention to the changes and factors related to glomerular filtration rate,and regularly monitor glomerular filtration rate,early diagnosis and early intervention of kidney damage in psoriasis patients.