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Turkish Journal of Medical Sciences

Author ORCID Identifier

AHMET BURAK DİRİM: 0000-0003-2262-8627

VAFA SULEYMANOVA: 0000-0002-5184-4188

OZGE HURDOGAN: 0000-0001-8352-8158

ÖZGÜR OTO: 0000-0003-0928-8103

AYŞE ARTAN: 0000-0002-6461-3178

SAVAS OZTURK: 0000-0002-0961-3810

YASEMİN OZLUK: 0000-0002-7191-0488

ISİN KİLİCASLAN: 0000-0002-4206-9941

HALİL YAZİCİ: 0000-0003-2526-3483

DOI

10.55730/1300-0144.5907

Abstract

Background/aim: Sarcoidosis is a multisystem disorder that affects many organs, including the kidneys. This single-center retrospective study investigated the clinical, pathological, and laboratory findings of patients with kidney sarcoidosis who were treated with immunosuppressives.Materials and Methods: Twenty-three patients with biopsy-confirmed kidney sarcoidosis were included. Demographics, clinical, pathological, and laboratory findings, in addition to treatments, and outcomes of twenty patients with at least one month of follow-up were evaluated.Results: Median age at the time of biopsy was 47 years(60.9 % female). Median baseline eGFR and proteinuria were 21.5 ml/min and 1 g/g or g/day, respectively. Nineteen of the 23 patients were diagnosed with non-glomerular disease (Four patients had glomerular diseases). Extrarenal sarcoidosis was present in 86.7% of patients. Granulomatous interstitial nephritis(56.5 %) and nephrosclerosis with intratubular calcific casts(17.4 %) were the two most common diagnoses. All patients initially received 1 mg/kg/day steroids for kidney involvement. Although no statistical difference was observed in kidney function during follow-up, steroids improved eGFR in the first month compared with baseline in patients with non-glomerular diseases(p=0.049). Eventually, 45 % of the patients developed end-stage-kidney-disease, and 45 % of cohort had a treatment response. Patients with higher baseline calcium levels(p=0.03) and lower degrees of interstitial fibrosis/tubular atrophy(p=0.043) had better kidney outcomes. Moreover, none of the patients with sarcoidosis-related secondary glomerular disease had a treatment response(p=0.043).Conclusions: Hypercalcemia and lower IF/TA rates might be associated with better outcomes in sarcoidosis-related kidney involvement under immunosuppressives. Also, late diagnosis, irregular follow-up, and glomerular disorders could be poor prognostic factors.

Keywords

glomerulonephritis, granulomatous interstitial nephritis, prognosis, Sarcoidosis

First Page

1252

Last Page

1264

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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