RESEARCH - Renal involvement and followup of 130 patients with primary Sjogren's syndrome

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J Rheumatol. 2008 Feb;35(2):278-84. Epub 2007 Dec 15.

Renal involvement and followup of 130 patients with primary Sjögren's syndrome.

Ren H, Wang WM, Chen XN, Zhang W, Pan XX, Wang XL, Lin Y, Zhang S, Chen N.

Department of Nephrology, Ruijin Hospital affiliated to Shanghai

Jiaotong University, School of Medicine, Shanghai, PR China.

OBJECTIVE: To identify the clinical characteristics, pathological

changes, and outcome of patients with primary Sjögren's syndrome

(pSS). METHODS: All patients with pSS and renal involvement who were

admitted to Ruijin Hospital from April 1993 to December 2006 were

included. All the data of clinical features and pathological changes

were retrospectively analyzed. Forty-one patients underwent renal

biopsies. RESULTS Our study included 130 patients with pSS: 122 women

and 8 men. Ages ranged from 16 to 68 years (mean 44.1 +/- 11.52).

Ninety-five patients (73.1%) developed renal tubular acidosis (RTA);

91 were found to have distal RTA. Nine patients presented with

hypokalemic paralysis. Four patients developed Fanconi syndrome and 3

were proved to have nephrogenic diabetes insipidus. Twenty-seven of

130 patients (20.8%) developed tubular proteinuria and 18/130 (13.8%)

presented glomerular involvement. Thirty-five patients (27.7%)

developed renal failure (serum creatinine > 115 micromol/l). Most

patients (70.8%) had increased serum IgG levels. The incidence of

chronic interstitial nephritis was 80.5% among all the biopsy

materials. Immunofluorescent staining was negative in most renal

tissue. Ninety-six patients were treated with corticosteroids and/or

immunosuppressant. Eighteen recovered renal function.

CONCLUSION: Patients with pSS commonly present with renal impairment,

mainly from renal tubular dysfunction. The combination of

corticosteroids and immunosuppressors significantly improves the renal

function of patients with pSS. There is a correlation between

hypergammaglobulinemia and distal RTA. The renal acidification

capacity for patients with hypergammaglobulinemia. should be

monitored.

PMID: 18085734

http://www.ncbi.nlm.nih.gov/pubmed/18085734

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