Navigating renal safety in the biologic treatment of psoriasis: from immunologic mechanisms to clinical practice
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By
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Zijie Tang
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Jintong Wu
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Meihan Dong
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Chengxin Li
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Rui Wang
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May 1, 2026
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Clinical Scorecard: Assessing Kidney Safety in Biologic Therapies for Psoriasis: Insights from Immunological Mechanisms to Clinical Applications
At a Glance
| Category | Detail |
|---|
| Condition | Psoriasis |
| Key Mechanisms | Immune regulation, inflammation suppression, and cell death pathways |
| Target Population | Patients with moderate to severe psoriasis, especially those with renal concerns |
| Care Setting | Multidisciplinary approach involving dermatologists, nephrologists, and immunologists |
Key Highlights
- Biologics have transformed psoriasis management but raise concerns about renal safety.
- Chronic systemic inflammation in psoriasis contributes to renal injury.
- Biologic therapy does not show higher CKD incidence compared to conventional therapies.
- Case reports indicate potential safety of biologics in patients with ESRD or IgAN.
- Monitoring and multidisciplinary management are essential for balancing benefits and risks.
Guideline-Based Recommendations
Diagnosis
- Assess renal function in psoriasis patients, especially those with moderate to severe disease.
Management
- Consider biologic therapies while evaluating renal safety profiles.
Monitoring & Follow-up
- Vigilant monitoring of renal function is necessary during biologic therapy.
Risks
- Potential direct nephrotoxicity and altered immune surveillance leading to infections.
Patient & Prescribing Data
Patients with psoriasis at risk for CKD or with existing renal impairment.
Biologics may mitigate systemic inflammation and improve renal outcomes.
Clinical Best Practices
- Integrate insights from dermatology, nephrology, and immunology for treatment planning.
- Tailor biologic therapies to maximize efficacy while minimizing renal adverse effects.
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