Clinical and Morphological Features of Kidney Involvement in Primary Sjogren’s Syndrome

Jul 13, 2026

This study investigated the prevalence and characteristics of kidney involvement in 60 Italian patients with primary Sjogren’s syndrome. Renal laboratory tests and functional evaluations (including water deprivation and ammonium chloride loading tests) were performed, and renal biopsies were done in patients with involvement. Results showed 27% with tubular and/or glomerular dysfunction, usually without overt clinical signs, and renal findings could precede sicca symptoms.

LanguageEnglish

CategoryHealthcare

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Nephrol Dial Transplant (2001) 16: 2328–2336 Original Article Clinical and morphological features of kidney involvement in primary Sjgren’s syndrome Nicola Bossini 1, Silvana Savoldi 1, Franco Franceschini2, Simone Mombelloni 1, Manuela Baronio2, Ilaria Cavazzana2, Battista Fabio Viola 1, Brunella Valzorio 1, Consuela Mazzucchelli 1, Roberto Cattaneo2, Francesco Scolari3 and Rosario Maiorca 1 1Division of Nephrology and 2Service of Clinical Immunology, Spedali Civili and Universita` , Brescia and 3Division of Nephrology, Universita` dell’Insubria, Varese, Italy Abstract Background. Primary Sjgren’s syndrome is a connective tissue disorder affecting primarily the lacrimal and salivary glands, resulting in xerophtalmia and xerostomia. Extraglandular manifestations are frequent and may include renal involvement. Methods. We studied the prevalence and nature of kidney involvement in 60 Italian patients with primary Sjgren’s syndrome, diagnosed according to the European classiﬁcation criteria. The following renal laboratory tests were performed in all patients: electrolytes in serum and in 24-h urine, creatinine in serum and in 24-h urine, venous pH and HCO–3, urinalysis, urine culture, urinary osmolality and urine pH. A water deprivation test was performed in patients with morning urine osmolalities below the reference values adjusted for age. An oral ammonium chloride loading test was performed in patients with urine pH above 5 . 5 from morning samples. Renal biopsy was performed in patients with renal involvement. Results. Sixteen patients (27%) had laboratory evidence of tubular anduor glomerular dysfunction. A variable degree of creatinine clearance reduction was found in eight patients (13%); frank distal tubular acidosis in three (5%); hypokalaemia in four (7%); and pathological proteinuria in 12 (20%) . Urine concentrating capacity was defective in 10 out of 48 (21%) tested patients. Only four patients presented with overt clinical manifestations, including hypokalaemic tetraparesis (1), nephrotic syndrome (2), recurrent renal stones with ﬂank pain and haematuria (1) . In two patients, signs of renal involvement preceded the onset of sicca syndrome. Renal biopsies Correspondence and offprint requests to: Dr Francesco Scolari, Division of Nephrology, Spedali Civili, Piazza Spedali Civili 1, I-25125 Brescia, Italy. Email: [fscolar@tin.it](fscolar@tin.it) from nine patients showed tubulo-interstitial nephritis in six and glomerular disease in three. Patients with renal involvement had a signiﬁcantly shorter disease duration compared with patients without renal abnormalities. Conclusions. Kidney involvement is a frequent extraglandular manifestation of primary Sjgren’s syndrome. It is rarely overt and may precede the onset of subjective sicca syndrome. Keywords: defective urine concentrating capacity; glomerulonephritis; renal tubular acidosis; Sjgren’s syndrome; tubulointerstitial nephritis Introduction Sjgren’s synd

Jul 13, 2026

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