Renal Involvement in Psoriasis

Psoriasis Kidney dysfunction β2-Microglobulin Microvasculature Dr. Mete F. Toppare, Alaçam Sok. No 12/12, Çankaya 06690 Ankara (Turkey) In psoriasis, the presence of intercellular adhesion molecule 1, endothelial leukocyte adhesion molecule and angiogenic factor in the dermal papillary vascular endothelium predicts microvascular involvement [1]; however, evidence of systemic vascular involvement is still scarce. In psoriatic patients with diffuse involvement, renal impairment and cardiovascular diseases are reported to occur [2]. We have recently studied the renal functions of psoriatic patients with moderately extensive skin involvement in search of kidney dysfunction. Thirty-five patients with histologically documented psoriasis were enrolled as the patient group after informed consent had been obtained. The duration of the disease, the disease severity (%) and the ESI score (erythema, squame, inflammation) were recorded. A group of healthy and agematched controls (n = 36) was also included. Serum albumin, blood urea nitrogen (BUN), serum creatinine, routine urinalysis, urine creatinine, creatinine clearance, urine microalbumin and urine ß2-microglobulin were quantitatively determined in the patient and control groups. All the subjects in both groups underwent renal ultrasonographic examination. Urine ß2-microglobulin was determined by a solid-phase immu-noradiometric assay (Coat-ACount IRMA). The assay was based on monoclonal and polyclonal anti-ß2-microglobulin antibodies: one l25-I-labeled anti-ß‚-microglobulin monoclonal antibody in liquid phase and one polyclonal anti-ß2-microglobulin antibody immobilized to the wall of a polystyrene tube. The pH of urine was adjusted to 7 adding 1.0 M NaOH. The samples were then stored at -20 °C for a period of not more than 4 weeks until analysis. Urine microalbumin was determined by a competitive radioimmunoassay in which l2T-labeled albumin competes with albumin in the patient sample for antibody sites. The procedure has a detection limit of approximately 0.3 μg/ml. The general characteristics of the groups are given in table 1. All the measured parameters of renal functions with the exception of ß2-microglobulin (p = 0.047) were similar. Multiple regression analysis revealed that no factor significantly affected the ß2-microglobulin levels;