Background Chronic plaque psoriasis has been associated with metabolic comorbidities, including non-alcoholic fatty liver disease (NAFLD). A causal relationship between NAFLD and chronic kidney disease (CKD) is debated. Objectives To assess whether NAFLD is associated with impaired renal function in patients with psoriasis. Methods A multicenter, retrospective, observational study including 337 patients with moderate-to-severe chronic plaque psoriasis, who had no history of excessive alcohol consumption or other secondary causes of chronic liver and renal diseases was conducted. NAFLD was diagnosed by ultrasonography, and CKD stage >= 2 or stage >= 3 were defined by an estimated glomerular filtration rate (e-GFR) of <90 ml min(-1) 1.73 m(-2) or <60 ml min(-1) 1.73 m(-2), respectively. Logistic and linear regression analyses were undertaken to assess the independent association of NAFLD with CKD or eGFR levels. Results Patients with NAFLD (n = 212, 62.9% of total) had significantly lower e-GFR levels (83.4 +/- 18.0 vs. 93.5 +/- 15.8 ml min(-1) 1.73 m(-2), P<.001) and a remarkably higher prevalence of both CKD stage >= 2 (56.1% vs. 30.4%, P<.0001) and CKD stage >= 3 (10.4% vs. 3.2%, P<.0001) compared with their counterparts without NAFLD. Multivariable logistic regression analysis showed that NAFLD was associated with a nearly 2.5-fold increased risk of prevalent CKD stage >= 2 (adjusted-odds ratio= 2.60 95% confidence intervals 1.4-4.8, P=.02), independently of components of metabolic syndrome, psoriasis severity, and psoriatic arthritis. Conclusions Ultrasound-diagnosed NAFLD is strongly associated with a reduced eGFR in patients with moderate-to-severe psoriasis, independently of cardiometabolic risk factors and psoriasis-related variables.

Non-Alcoholic Fatty Liver Disease Is Associated With Reduced Glomerular Filtration Rate in Patients With Chronic Plaque Psoriasis

Bellinato, Francesco;Goio, Isotta;Targher, Giovanni;Girolomoni, Giampiero;Gisondi, Paolo
2022

Abstract

Background Chronic plaque psoriasis has been associated with metabolic comorbidities, including non-alcoholic fatty liver disease (NAFLD). A causal relationship between NAFLD and chronic kidney disease (CKD) is debated. Objectives To assess whether NAFLD is associated with impaired renal function in patients with psoriasis. Methods A multicenter, retrospective, observational study including 337 patients with moderate-to-severe chronic plaque psoriasis, who had no history of excessive alcohol consumption or other secondary causes of chronic liver and renal diseases was conducted. NAFLD was diagnosed by ultrasonography, and CKD stage >= 2 or stage >= 3 were defined by an estimated glomerular filtration rate (e-GFR) of <90 ml min(-1) 1.73 m(-2) or <60 ml min(-1) 1.73 m(-2), respectively. Logistic and linear regression analyses were undertaken to assess the independent association of NAFLD with CKD or eGFR levels. Results Patients with NAFLD (n = 212, 62.9% of total) had significantly lower e-GFR levels (83.4 +/- 18.0 vs. 93.5 +/- 15.8 ml min(-1) 1.73 m(-2), P<.001) and a remarkably higher prevalence of both CKD stage >= 2 (56.1% vs. 30.4%, P<.0001) and CKD stage >= 3 (10.4% vs. 3.2%, P<.0001) compared with their counterparts without NAFLD. Multivariable logistic regression analysis showed that NAFLD was associated with a nearly 2.5-fold increased risk of prevalent CKD stage >= 2 (adjusted-odds ratio= 2.60 95% confidence intervals 1.4-4.8, P=.02), independently of components of metabolic syndrome, psoriasis severity, and psoriatic arthritis. Conclusions Ultrasound-diagnosed NAFLD is strongly associated with a reduced eGFR in patients with moderate-to-severe psoriasis, independently of cardiometabolic risk factors and psoriasis-related variables.
chronic kidney disease
non-alcoholic fatty liver
psoriasis
Glomerular Filtration Rate
Humans
Retrospective Studies
Risk Factors
Non-alcoholic Fatty Liver Disease
Psoriasis
Renal Insufficiency, Chronic
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1068148
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