Renal disease in sarcoidosis patients in a German multicentric retrospective cohort study - 04/03/23
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Abstract |
Introduction |
Sarcoidosis is a systemic granulomatous disease potentially affecting every organ system. Renal involvement is reportedly rare, and the evidence consists of case reports and cohort studies. Systematic investigations are scarce and show a varying prevalence ranging from <1% to 30–50%.
Methods |
We retrospectively analyzed data from patients with a recent diagnosis of sarcoidosis from five tertiary care centers focusing on renal sarcoidosis.
Results |
We analyzed data from 327 patients with sarcoidosis between 2001 and 2021. Of 327 patients, 109 (33.3%) had probable or definite renal sarcoidosis. 90 (27.5%) had histopathologic confirmation. 57 (64%) had an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2. The most prominent associated finding was an elevated soluble interleukin-2 receptor. Patients with renal sarcoidosis more frequently received glucocorticoids than other non-renal sarcoidosis patients (92% vs. 78%, p < 0.01). Also, azathioprine (38% vs. 16%, p < 0.001) and mycophenolate mofetil (5% vs. 1%, p < 0.05) were more frequently used in renal sarcoidosis compared to non-renal sarcoidosis, whereas methotrexate was used less frequently (7% vs. 17%, p < 0.05).
Conclusions |
Our data of the largest cohort with biopsy-confirmed renal sarcoidosis demonstrate a higher prevalence (27.5% of all patients) than previously published with a relevant disease burden. The urinary findings in most cases were only mildly abnormal, and some patients did not have renal biopsy despite abnormal urinary results. A renal workup should be performed in all patients with a new diagnosis of sarcoidosis.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The prevalence of renal sarcoidosis was 27.5% in a multicentric German cohort. |
• | Patients with renal sarcoidosis received glucocorticoids, azathioprine, and mycophenolate mofetil more frequently. |
• | Higher soluble interleukin-2 receptor (sIL-2R) levels were associated with an eGFR <60 ml/min/1.73m2. |
• | Renal sarcoidosis cases had either eGFR <60 ml/min/1.73 m2, proteinuria >300 mg/g creatinine, or pathologic sediment + sIL-2R. |
• | A dedicated renal workup should be performed in all patients with a recent diagnosis of sarcoidosis. |
Keywords : Sarcoidosis, Interstitial nephritis, Chronic kidney failure, Biomarkers
Plan
Vol 209
Article 107121- avril 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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