Psoriasis and risk of chronic kidney disease: a meta-analysis

The association of psoriasis and renal disease remains controversial. We conducted this meta-analysis to determine the association between psoriasis and risk of chronic kidney disease (CKD) or end-stage renal disease (ESRD). PubMed and Embase were searched for observational studies published up to May 2017. Both retrospective and prospective studies that reported risk estimate of incident CKD or ESRD for patients with psoriasis versus participants without psoriasis. Four observational studies were included in the final analysis. Meta-analysis showed that psoriasis was associated with an increased risk of CKD (hazard ratio [HR] = 1.14; 95% confidence interval [CI] = 1.03-1.26) but not ESRD (HR = 1.14; 95% CI = 0.92-1.42). Subgroup analysis indicated that severe psoriasis significantly increased both CKD (HR = 1.73; 95% CI = 1.36-2.21) and ESRD (HR = 3.25; 95% CI = 2.04-5.18). However, mild psoriasis was not associated with an increased risk of CKD (HR = 1.09; 95% CI = 0.91-1.30) and ESRD (HR = 0.94; 95% CI = 0.73-1.20). This meta-analysis confirms that patients with severe psoriasis but not mild psoriasis have an increased risk of CKD or ESRD. Screening for renal disease in psoriatic patients may be warranted.