Clinical characteristics of biopsy-proven renal sarcoidosis in Japan

Yoshinori Kamata, Hiroshi Sato, Kensuke Joh, Yoshinori Tsuchiya, Shinobu Kunugi, Akira Shimizu, Tsuneo Konta, Robert P. Baughman, Arata Azuma

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: Although some articles have described renal sarcoidosis, the incidence among biopsy cases remains unclear. Here, we defned the incidence of renal sarcoidosis among renal biopsy cases and analyzed the clinical course. Methods: We performed an epidemiological study examining renal biopsy cases treated at 5 centers between January 2000 and September 2015 and identifed 16 cases (7 men, 9 women; mean (±SD) age, 59.4±18.6 years) out of a total of 14191 renal biopsy cases. Renal involvement of sarcoidosis was defned as granulomatous tubulointerstitial nephritis, tubulointerstitial nephritis without granulomatous lesions, and renal calcinosis. Fifteen of the cases were treated with steroid therapy. One case initially received steroid pulse therapy. Te outcome was evaluated based on the estimated glomerular fltration rate (eGFR), CKD stage, and the change in eGFR (δeGFR) after treatment. A favorable response was defned as δeGFR =25%. Results: Te incidence of renal sarcoidosis was 0.11%. Te mean eGFR was 28.2±16.1 mL/min/1.73 m2. At the last observation, the mean eGFR was 43.7±19.7 mL/min/1.73 m2. Although a favorable response to steroid therapy was found in the majority of cases (10/15, 67%), 12 of the 15 cases (80%) had residual renal dysfunction at the last observation and 8 cases (53%) had moderate to severe renal dysfunction. Conclusion: Renal sarcoidosis is extremely rare among renal biopsy cases. Among cases with an unfavorable response to steroid therapy, pathogenetic mechanisms other than sarcoidosis and severe nephron damage were observed.

Original languageEnglish
Pages (from-to)252-260
Number of pages9
JournalSarcoidosis Vasculitis and Diffuse Lung Diseases
Volume35
Issue number3
Publication statusPublished - 2018 Oct 18

Keywords

  • Epidemiological study
  • Renal biopsy
  • Renal sarcoidosis
  • Tubulointerstitial nephritis

ASJC Scopus subject areas

  • Internal Medicine
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

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