Objectives To study clinical and laboratory changes in kidney patients with psoriatic arthritis (PA).
Methods The study included 60 patients. The age of patients ranged from 22 to 60 years. All patients underwent clinical and laboratory study: functional kidney tests, general analysis of blood, Zimnitsky test, Reberg test, creatinine and urea levels.
Results Kidney disease was diagnosed in 25 (41,7%) patients. Nephropathy is directly related to the underlying disease, was detected in 18 (30.0%) patients, including chronic glomerulonephritis in 10 cases and renal amyloidosis in 6 cases. We failed to verify the nature of kidney impairment in 2 patients. There was the prevalence of men among patients with psoriatic nephropathy (in 17). Renal disease is seen in patients with other systemic manifestations of the PA, including the expressed trophic disorders (in 9), prolonged fever (in 5), lymphadenopathy (in 2), heart disease (in 6) and liver (in 3).
Urinary syndrome was characterized by transient proteinuria and small haematuria (in 19 cases), a significant and persistent haematuria (red blood cells up to 30–40–50 in sight with episodes of gross haematuria) at extremely low values of proteinuria (in 5), regularly or occasionally high proteinuria above 3g/day (in 5). Extrarenal symptoms was presented with persistent oedema (in 4), hypertension (in 5). Nephritic syndrome was diagnosed in 12 patients. Reduced concentration ability of the kidneys was observed in 17 patients, and expressed presentation of chronic renal failure in 5 cases. Bladder syndrome was usually observed at the beginning of the PA, in exacerbations of joint syndrome with generalization process or the development of an advanced stage of dermatosis. In some cases, slight proteinuria and haematuria accompanied by acute syndromes was a comorbidity of main PA for many years without any development of kidney damage or azotaemia. Renal amyloidosis was characteristic for being accompanied by the nephritic syndrome. Daily protein loss reached 6–8g, and the amount of protein in a disposable examination of urine - 10,5 g/l. The total protein content in the serum was reduced to 49 g/l. Changes in urine, except for proteinuria, characterized microhaematuria (in 5 patients), small leukocytes (in 6), granular and wax cylinders.
Conclusions Patients with PA in 41,7% cases had a variety of manifestations of the urinary syndrome. This represents the role of immediate diagnosis and correction of renal dysfunction; thus, chronic renal impairment may adversely affect prognosis of the disease.
Disclosure of Interest None declared
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