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Turkish Journal of Medical Sciences

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.

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

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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