Chopra Amit, Brasher Paul, Chaudhry Haroon, Zheng Robert, Asif Arif, Judson Marc A
Department of Medicine, Pulmonary and Critical Care Medicine, Albany Medical Center, NY.
Department of Medicine, Albany Medical College, Albany, NY.
Sarcoidosis Vasc Diffuse Lung Dis. 2017;34(2):142-148. doi: 10.36141/svdld.v34i2.5297. Epub 2017 Apr 28.
While sarcoidosis has been recognized as a potential cause of proteinuria, no study has systematically evaluated the prevalence and risk factors for proteinuria in sarcoid patients. Consecutive sarcoid patients followed in a university clinic were identified prospectively. All patients with spot urine protein-to-creatinine ratio (UPCR) between 11-2012 and 07-2015 were included in the analysis. Proteinuria was defined as a spot UPCR equal to or exceeding 0.3 mg/mg. The primary goal of the study was to determine the prevalence of proteinuria in this sarcoidosis cohort. Our study cohort consisted of 190 sarcoidosis patients (65% female, 82% white, mean age of 53 years (range 24-88)). Proteinuria was present in 14/190 (7%) of this cohort. Only5/190 patients (2.5%) had proteinuria who did not have a risk factor for proteinuria. Estimating the 24-hour urine protein excretion by extrapolating from the spot UPCR, proteinuria was moderate in amount (mean 1.60, range 0.32-5.06 mg/mg). Proteinuric patients received a lower mean daily dose of corticosteroids compared to those without proteinuria (0 mg vs 4.7 mg of prednisone); however, this difference did not reach statistical significance (p = 0.20). Our study found proteinuria in 7% of the 190 sarcoid patients. More than half of the patients with proteinuria had a known risk factor for proteinuria other than sarcoidosis. Proteinuria is uncommon in sarcoidosis, and, when it occurs, it should not be assumed that sarcoidosis is the cause without investigating alternative causes of proteinuria. .
虽然结节病已被认为是蛋白尿的一个潜在原因,但尚无研究系统评估结节病患者蛋白尿的患病率及危险因素。前瞻性地确定了在大学诊所随访的连续结节病患者。分析纳入了2012年11月至2015年7月期间所有随机尿蛋白肌酐比值(UPCR)的患者。蛋白尿定义为随机UPCR等于或超过0.3mg/mg。该研究的主要目的是确定该结节病队列中蛋白尿的患病率。我们的研究队列由190例结节病患者组成(65%为女性,82%为白人,平均年龄53岁(范围24 - 88岁))。该队列中有14/190(7%)存在蛋白尿。只有5/190例患者(2.5%)有蛋白尿且无蛋白尿危险因素。通过从随机UPCR外推估计24小时尿蛋白排泄量,蛋白尿程度为中度(平均1.60,范围0.32 - 5.06mg/mg)。与无蛋白尿患者相比,蛋白尿患者接受的皮质类固醇平均日剂量较低(泼尼松0mg vs 4.7mg);然而,这种差异未达到统计学意义(p = 0.20)。我们的研究发现190例结节病患者中有7%存在蛋白尿。超过一半的蛋白尿患者除结节病外还有已知的蛋白尿危险因素。蛋白尿在结节病中并不常见,当出现蛋白尿时,在未调查蛋白尿的其他原因之前,不应假定结节病是病因。