Kamata Yoshinori, Konta Tsuneo, Nakano Toshiaki, Masuzawa Naoko, Ichikawa Kazunobu, Ozeki Takaya, Maruyama Shoichi
Department of Public Health and Hygiene, Yamagata University Graduate School of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Fukuoka, Japan.
Clin Exp Nephrol. 2025 Apr 30. doi: 10.1007/s10157-025-02688-7.
In sarcoidosis, renal involvement is less common than lung involvement. Epidemiology and clinical characteristics of the patients with renal involvement are largely unknown.
From the database of the Japan Renal Biopsy Registry (J-RBR), the patients who were diagnosed with renal involvement of sarcoidosis such as sarcoidosis-related tubulointerstitial nephritis or renal calcinosis were extracted. The prevalence and clinical characteristics of these cases were analyzed. After removing the cases with concomitant glomerular diseases or renal calcinosis, the correlation between urinary protein-creatinine ratio (UPCR) and eGFR or serum albumin levels were evaluated by Pearson's correlation (r). In addition, distributions of serum albumin levels were compared across the categories of urinary albumin levels.
Among the 55,885 participants in the J-RBR database, 135 patients (66 men and 69 women, 0.24% of total registration) had renal involvement of sarcoidosis including nine cases with concomitant glomerular diseases: nephrosclerosis (n = 4), IgA nephropathy (n = 2), diabetic nephropathy (n = 2) and unclassified (n = 1). Mean value (± standard deviation) of age was 62 ± 14, eGFR was 30.7 ± 15.2, and UPCR was 0.50 ± 0.68. Among the patients without any concomitant glomerular disease or renal calcinosis, UPCR was negatively correlated with eGFR (r = - 0.531, p < 0.001) and serum albumin level (r = - 0.352, p < 0.001).
Data from a nationwide biopsy registry revealed that main forms of histopathology of renal involvement of sarcoidosis was tubulointerstitial nephritis and these cases were common in older adults. The intensity of the tubulointerstitial nephritis may be related to the degree of renal dysfunction and proteinuria.
在结节病中，肾脏受累比肺部受累少见。肾脏受累患者的流行病学和临床特征在很大程度上尚不清楚。
从日本肾活检登记处（J-RBR）数据库中，提取诊断为结节病肾脏受累的患者，如结节病相关的肾小管间质性肾炎或肾钙质沉着症。分析这些病例的患病率和临床特征。去除合并肾小球疾病或肾钙质沉着症的病例后，通过Pearson相关性（r）评估尿蛋白肌酐比值（UPCR）与估算肾小球滤过率（eGFR）或血清白蛋白水平之间的相关性。此外，比较不同尿白蛋白水平类别中血清白蛋白水平的分布情况。
在J-RBR数据库的55885名参与者中，135例患者（66名男性和69名女性，占总登记人数的0.24%）有结节病肾脏受累，其中9例合并肾小球疾病：肾硬化（n = 4）、IgA肾病（n = 2）、糖尿病肾病（n = 2）和未分类（n = 1）。年龄的平均值（±标准差）为62±14，eGFR为30.7±15.2，UPCR为0.50±0.68。在没有任何合并肾小球疾病或肾钙质沉着症的患者中，UPCR与eGFR呈负相关（r = -0.531，p < 0.001），与血清白蛋白水平呈负相关（r = -0.352，p < 0.001）。
来自全国活检登记处的数据显示，结节病肾脏受累的主要组织病理学形式是肾小管间质性肾炎，这些病例在老年人中很常见。肾小管间质性肾炎的严重程度可能与肾功能不全和蛋白尿的程度有关。
