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 a risk of an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2.
- •Almost all patients with biopsy-confirmed renal sarcoidosis had an eGFR <60 ml/min/1.73 m2, proteinuria >300 mg/g creatinine, or a pathologic urine sediment combined with an elevated soluble interleukin-2 receptor.
- •A dedicated renal workup should be performed in all patients with a recent diagnosis of sarcoidosis.
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.
Keywords
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Article info
Publication history
Accepted:
January 16,
2023
Received in revised form:
January 4,
2023
Received:
April 21,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
