Saudi Journal of Kidney Diseases and Transplantation

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 30  |  Issue : 6  |  Page : 1276--1284

Tubulointerstitial nephritis due to sarcoidosis: Clinical, laboratory, and histological features and outcome in a cohort of 24 patients


Asma Zammouri1, Samia Barbouch2, Mariem Najjar1, Raja Aoudia1, Fatima Jaziri1, Hayet Kaaroud1, Hafedh Hedri1, Ezzeddine Abderrahim2, Rim Goucha1, Fethi Ben Hamida2, Amel Harzallah1, Taieb Ben Abdallah3 
1 Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia
2 Department of Nephrology; Laboratory Department of Renal Pathology Research (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia
3 Department of Nephrology; Laboratory Department of Kidney Transplantation, Immunology and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis, Tunisia

Correspondence Address:
Asma Zammouri
Department of Nephrology, Charles Nicolle Hospital, Tunis
Tunisia

Renal involvement is rare in systemic sarcoidosis. Among renal manifestations, tubulointerstitial nephritis (TIN) is the most commonly reported finding. We conducted the current study to investigate the clinical, laboratory, and histological features and to analyze the outcome of TIN due to sarcoidosis. We present a retrospective, single-center study of patients followed for sarcoidosis and presenting with TIN related to this systemic disease. Twenty-four patients were assessed (22 females/2 males). The mean age at diagnosis of TIN was 46.3 years. Extrarenal manifestations were dominated by thoracic involvement (95.8%), peripheral lymph nodes (54.2%), and skin lesions (33.3%). The mean proteinuria level was 0.68 g/24 h. Renal failure was diagnosed in 83.3% of cases with a median estimated glomerular filtration rate at 14.3 mL/min/1.73 m2. Nine patients presented with hypercalcemia and 12 patients with hypercalciuria. Renal biopsy was performed in 58.3% of cases. Six of the 14 patients presented with noncaseating granulomatous interstitial nephritis and eight with interstitial nephritis without granuloma. Granulomatous infiltration of renal parenchyma was complicated by vasculitis in two cases. Corticosteroid therapy was used in all patients. On follow-up analysis, four patients progressed to end-stage renal disease (ESRD) after a mean duration at 45.5 months. In the remaining patients, kidney function statistically significantly improved after one month of treatment compared to the time when the diagnosis was initially established (P = 0.031). We found that the predictive factors of progression to ESRD were multiorgan involvement (P = 0.032), advanced fibrosis F3 (P = 0.0006), and extensive interstitial granulomas (P = 0.007) and these were independently correlated with ESRD. Corticosteroid therapy seems to be effective in sarcoid TIN, but some degree of persistent renal failure is possible which can be predicted from both histologic findings and initial response to steroid therapy.


How to cite this article:
Zammouri A, Barbouch S, Najjar M, Aoudia R, Jaziri F, Kaaroud H, Hedri H, Abderrahim E, Goucha R, Hamida FB, Harzallah A, Abdallah TB. Tubulointerstitial nephritis due to sarcoidosis: Clinical, laboratory, and histological features and outcome in a cohort of 24 patients.Saudi J Kidney Dis Transpl 2019;30:1276-1284


How to cite this URL:
Zammouri A, Barbouch S, Najjar M, Aoudia R, Jaziri F, Kaaroud H, Hedri H, Abderrahim E, Goucha R, Hamida FB, Harzallah A, Abdallah TB. Tubulointerstitial nephritis due to sarcoidosis: Clinical, laboratory, and histological features and outcome in a cohort of 24 patients. Saudi J Kidney Dis Transpl [serial online] 2019 [cited 2022 May 25 ];30:1276-1284
Available from: https://www.sjkdt.org/article.asp?issn=1319-2442;year=2019;volume=30;issue=6;spage=1276;epage=1284;aulast=Zammouri;type=0