Psoriasis and IGA nephropathy link, has anyone ever heard of this?

[ccarr06]

I'm posting this thread here, I hope I have it in the right place. If not, please let me know.

For anyone who has read my journal, you'll know I was recently diagnosed with IGA nephropathy. (For those who don't know what this is, it's basically a build up of protein on my kidneys that could possibly affect their function down the line)

While talking to the nephrologist, he mentioned that there was link between psoriasis and IGA N, that psoriasis can trigger protein changes in the urine. Has anyone else ever heard of this? Is there anyone else who has had protein abnormalities in their urine samples?

[Fred]

Yes it's in the right place. I don't recall anything specific but wondered if these threads are of interest.

Severe psoriasis increases risk of kidney disease

Psoriasis patients have higher risk of kidney disease

Increased risk of Kidney disease in psoriasis patients.

Psoriasis and chronic kidney disease study

[jiml]

Hi CC I'm afraid it's not a link I have heard of but I'm in regular contact with the renal team at our local hospital as my wife has failed kidneys ....so next week when I'm at the hospital I will ask the team there if they know of a link ...
In the meantime I hope someone else will come up with an answer for you

[Caroline]

Out of the pharmaceutical paper from Germany.

Quote:

---

Neben der Psoriasis-Arthritis, von der jeder fünfte Patient mit Schuppenflechte betroffen ist, sind unter anderem die Inzidenzen von Adipositas, Dyslipidämie, Diabetes, Bluthochdruck, chronisch-entzündlichen Darmerkrankungen und Depressionen bei Psoriasis-Patienten erhöht (lesen Sie dazu auch PZ 19/2013: Komorbiditäten: Psoriasis geht unter die Haut). Darüber hi­naus gab es in kleineren Studien immer wieder Hinweise darauf, dass auch die Nieren von der chronisch-entzündlichen Erkrankung in Mitleidenschaft gezogen werden. Forscher um Professor Dr. Joel M. Gelfand von der University of Pennsylvania untersuchten diesen Verdacht jetzt mittels einer populationsbasierten Kohortenstudie.

Bei Patienten mit schwerer Psoriasis leidet nicht nur die Haut, sondern unter anderem auch die Nieren.


Sie analysierten die Daten von 136 529 Patienten mit leichter und 7354 Patienten mit schwerer Psoriasis sowie von 689 702 Kontrollpersonen aus einem britischen elektronischen Patientenverzeichnis. Mittelschwere bis schwere, nicht aber leichte Psoriasis war mit einem erhöhten Risiko für ein chronisches Nierenleiden assoziiert, berichten die Wissenschaftler im »British Medical Journal« (doi: 10.1136/bmj.f5961). Das Risiko stieg mit dem Alter. Die Forscher errechneten anhand ihrer Ergebnisse, dass schwere Psoriasis bei 40- bis 50-Jährigen für einen zusätzlichen Fall chronischer Nephropathie pro 134 Patienten und Jahr verantwortlich ist, in der Altersgruppe der 50- bis 60-Jährigen sogar für einen zusätzlichen Fall pro 62 Patienten jährlich.

Der Zusammenhang bestand unabhängig von klassischen Risikofaktoren wie Diabetes, Bluthochdruck und Einnahme nephrotoxischer Arzneistoffe. Der zugrunde liegende Mechanismus ist noch unklar, doch vermuten die Autoren Störungen der T-Zell-Funktion und erhöhte Level von Immunkomplexen als mögliche Ursache. Als weitere mögliche Erklärung schlagen sie Schäden der Tubuli durch erhöhte Harnsäurespiegel vor.

Nierenfunktion testen

Als Konsequenz für die Praxis raten die Forscher zu einer engmaschigen Überwachung der Nierenfunktion bei Patienten mit Psoriasis-Läsionen auf mindestens 3 Prozent der Körperoberfläche. Vor Einsatz potenziell nephrotoxischer Arzneistoffe wie Ciclosporin oder Methotrexat sollte bei ihnen eine besonders kritische Nutzen-Risiko-Abwägung erfolgen.

Don't know if you can read it but basically it says: yes, there is a link. They researched 136.000 patients.
The chance increases with age. 40-50 years one in 134 patients.
50-60 years one in 64 patients per year.
They cannot find the "why" it happens.

Last sentence is very interesting as it says: be aware with cyclosporine and MTX as they are potentially nephrotoxic.

[Caroline]

Oh, Jim sent me a translation of this article. He is so nice.    

Quote:

---

Quote:
Besides psoriatic arthritis, of the one in five patients affected with psoriasis, including the incidence of obesity, dyslipidemia, diabetes, hypertension, chronic inflammatory bowel disease and depression are increased in psoriasis patients (see, however, PZ 19/2013 : comorbidities: psoriasis is more than skin). In addition, there were smaller studies again evidence that the kidneys are drawn from the chronic inflammatory disease suffer. Researchers led by Professor Dr. Joel M. Gelfand of the University of Pennsylvania studied these suspicions now by means of a population-based cohort study.

In patients with severe psoriasis not only the skin, but, among other things, the kidney suffers.


They analyzed data from 136,529 patients with mild and 7354 patients with severe psoriasis, as well as 689 702 control subjects from a British electronic patient folder. Moderate to severe but not mild psoriasis was associated with an increased risk for chronic kidney disease, the scientists report in the "British Medical Journal" (doi: 10.1136 / bmj.f5961). The risk increased with age. The researchers calculated based on their results indicate that severe psoriasis in 40- to 50-year-old is responsible for an additional case of chronic nephropathy per 134 patients per year, every year in the age group of 50- to 60-year-old even for an extra case per 62 patients ,

The relationship was independent of traditional risk factors such as diabetes, hypertension and taking nephrotoxic drugs. The underlying mechanism is still unclear, but the authors suggest disorders of T-cell function and increased levels of immune complexes as a possible cause. Another possible explanation they suggest damage the tubules ago by elevated levels of uric acid.

test kidney function

As a consequence, in practice, the researchers advise to close monitoring of renal function in patients with psoriatic lesions on at least 3 percent of body surface. Before using potentially nephrotoxic drugs such as cyclosporine or methotrexate, a particularly critical benefit-risk assessment should be done with them.

[Annalise]

I'm posting this thread here, I hope I have it in the right place. If not, please let me know.

For anyone who has read my journal, you'll know I was recently diagnosed with IGA nephropathy. (For those who don't know what this is, it's basically a build up of protein on my kidneys that could possibly affect their function down the line)

While talking to the nephrologist, he mentioned that there was link between psoriasis and IGA N, that psoriasis can trigger protein changes in the urine. Has anyone else ever heard of this? Is there anyone else who has had protein abnormalities in their urine samples?

Yes, I have heard about it from my research of IGA Nephropathy. I have psoriasis and was recently diagnosed with IGA Nephropathy in July of 2016. What was interesting is that in May, my nephrologist told me to start taking 4000 mg of Omega 3-6-9 Fish Oil everyday to see if it would help with kidney pain. Within a few weeks of starting it, I noticed that not only was it helping my kidney pain, but it was also clearing up my psoriasis.

[jiml]

I'm posting this thread here, I hope I have it in the right place. If not, please let me know.

For anyone who has read my journal, you'll know I was recently diagnosed with IGA nephropathy. (For those who don't know what this is, it's basically a build up of protein on my kidneys that could possibly affect their function down the line)

While talking to the nephrologist, he mentioned that there was link between psoriasis and IGA N, that psoriasis can trigger protein changes in the urine. Has anyone else ever heard of this? Is there anyone else who has had protein abnormalities in their urine samples?

Yes, I have heard about it from my research of IGA Nephropathy. I have psoriasis and was recently diagnosed with IGA Nephropathy in July of 2016. What was interesting is that in May, my nephrologist told me to start taking 4000 mg of Omega 3-6-9 Fish Oil everyday to see if it would help with kidney pain. Within a few weeks of starting it, I noticed that not only was it helping my kidney pain, but it was also clearing up my psoriasis.

hi Annalise and    to the club. I'm sure you will find the site interesting as it only comprises of sufferers experiences of treatments and that they are using, so we can all gauge the effectiveness of the various treatments without the bias of health professionals
It's a friendly place to come and be with people that also suffer with the disease
There is a great database here for you to search and also a busy off topic section if you  want something a bit light hearted

I'm Glad the Omega fish oil has had such a positive affect on not only your kidneys but also your psoriasis , so thank you for sharing and I'm sure others will be interested in your experience as well

Jim

[Krissie_Wright]

Hi ccar,

I just thought I'd add some interesting abstracts from some research papers on Psoriatic IgA Nephropathy for you to have a read through...

There is a small amount of research into this and it is of particular interest to me as my granmother (from whom I inherited my psoriasis) passed due to kidney failure and I have long believed that there was a link to the severity of her psoriasis/psoiatic arthritis and her kidney issues.

That said, it is rare and those of us with P/PsA are more at risk of developing artherosclerosis (heart disease), chrones disease, diabetes etc.

If you need any links to the papers or help to decipher them just send me a pm.

Krissie

PAPER 1

Abstract

Psoriasis is an immune-mediated chronic inflammatory disorder of the skin. Association with kidney disease has been debated for a long time. Secondary renal amyloidosis in psoriatic arthropathy and drug-induced renal lesions secondary to methotrexate or cyclosporine are accepted accompaniments of psoriasis. IgA nephropathy is also known to occur in psoriatics. We report three interesting cases of renal involvement in long-standing established psoriasis on topical therapy alone. The patients presented with hypertension, significant proteinuria, hypoalbuminemia, and dyslipidemia. Kidney biopsies revealed "mesangioproliferative glomerulonephritis with IgA nephropathy," "focal proliferative glomerulonephritis," and "membranous glomerulonephropathy." The former two had marked active urinary sediment. Patients improved on prednisolone and angiotensin-converting enzyme inhibitors. Contrary to the belief that renal involvement in psoriasis is coincidental, we propose that kidney disease may be a common accompaniment of psoriasis, which may be labeled as "psoriatic nephropathy" or "psoriatic kidney disease." The exact mechanism of this entity is yet to be elucidated.


PAPER 2
Risk of moderate to advanced kidney disease in patients with psoriasis: population based cohort study

Abstract

Objective To determine the risk of chronic kidney disease in patients with psoriasis.

Design Population based cohort study and nested cross sectional study.

Setting Electronic medical records database based in United Kingdom.

Participants Cohort study: patients with psoriasis aged 18-90 each matched to up to five patients without psoriasis based on age, practice, and time of visit. Nested study: patients with psoriasis aged 25-64 with confirmed data on psoriasis severity, each matched to up to 10 patients without psoriasis based on age and practice.

Main outcome measures Cohort study: incident moderate to advanced (stage 3 through 5) chronic kidney disease. Nested study: baseline prevalence of chronic kidney disease.

Results 136 529 patients with mild psoriasis and 7354 patients with severe psoriasis based on treatment patterns were matched to 689 702 unaffected patients. The adjusted hazard ratios (95% confidence intervals) for incident chronic kidney disease were 1.05 (1.02 to 1.07), 0.99 (0.97 to 1.02), and 1.93 (1.79 to 2.08) in the overall, mild, and severe psoriasis groups, respectively. Age was a significant effect modifier in the severe psoriasis group, with age specific adjusted hazard ratios (95% confidence intervals) of 3.82 (3.15 to 4.64) and 2.00 (1.86 to 2.17) for patients aged 30 and 60, respectively. In the nested analysis of 8731 patients with psoriasis with measurements of affected body surface area matched to 87 310 patients without psoriasis, the adjusted odds ratios (95% confidence intervals) for chronic kidney disease were 0.89 (0.72 to 1.10), 1.36 (1.06 to 1.74), and 1.58 (1.07 to 2.34) in the mild, moderate, and severe psoriasis groups, respectively.

Conclusions Moderate to severe psoriasis is associated with an increased risk of chronic kidney disease independent of traditional risk factors.

---

Edit By Fred: Links Removed.

[ccarr06]

I know it's been a while since I made this thread, but I just wanted to say thanks to everyone who posted information on this, you guys have been very helpful as always!

[Caroline]

I know it's been a while since I made this thread, but I just wanted to say thanks to everyone who posted information on this, you guys have been very helpful as always!

thanks for your feedback.