Renal involvement in primary Sjögren's syndrome

Abstract

Renal involvement was evaluated in 62 patients with primary Sjögren's syndrome, classified according to criteria proposed by The European Classification Criteria Group. Urine concentration capacity was tested using intranasal 1-desamino-8-D-arginine-vasopressin. For patients with urine pH>5.5 without metabolic acidosis (n=28), an acidification test with ammonium chloride was performed. Urinary citrate, albumin, NAG, ALP and beta2-microglobulin were measured and creatinine clearance was calculated. Maximum urine concentration capacity and creatinine clearance were reduced in 13 (21%). Albumin excretion was >30 microg/min in only one patient (1.6%). Seven patients (11.3%) had complete or incomplete distal renal tubular acidosis (dRTA), four had reduced creatinine clearance and five had reduced maximum urine concentration capacity. The ratio of citrate/creatinine in spot urine was below the 2.5 percentile in all patients with complete or incomplete dRTA. The prevalence of dRTA was lower than in previous studies. There were also few patients with signs of glomerular disease (1.6%). The use of citrate:creatinine ratio in spot urine can be a helpful method in identifying patients with complete or incomplete dRTA.

Renal Involvement in Primary Sjögren's Syndrome

“…Renal tubular dysfunction as manifested by type 1 RTA, renal calculi, and hypokalemia are also common (42). Because TIN historically has been associated with pSS (33,43), it is certainly possible that patients with clinical evidence of renal involvement are not biopsied because of the assumption that these patients have TIN and hence are treated empirically without obtaining an accurate histopathologic diagnosis.…”

Tubulointerstitial Nephritis and Primary Biliary Cirrhosis with a T Cell-dominant Profile of Infiltrating Cells and Granulomas in Both Organs

“…The tubulointerstitial nephritis observed in Sjögren's syndrome (11,12) is sometimes found in patients with PBC (13). Tubulointerstitial nephritis caused by Sjögren's syndrome is associated with inflammatory cell infiltration consisting of lymphocytes, plasma cells and histiocytes (12).…”

Osteomalacia secondary to renal tubular acidosis due to Sjögren’s syndrome: a case report and review of the literature

“…Causes of distal RTA in adults include hypercalciuria and autoimmune diseases, such as SjS and rheumatoid arthritis [17]. Although distal RTA is reported to occur in 11-30 % of patients with SjS [2,18], the mechanism of distal RTA in SjS is not fully understood. Since urinary acidification in the collecting tubules is achieved via H ?…”

“…It is a systemic disease, with manifestations from several organ systems, such as lung, skin, gastrointestinal tract, central and peripheral nervous system, muscles, and the kidney [1]. Renal involvement, such as tubulointerstitial nephritis, renal tubular acidosis (RTA), and glomerular disease, may occur as an extraglandular manifestation of SjS [2]. Although RTA is one of the causes of osteomalacia [3], only a few case reports of osteomalacia with SjS have been published.…”