Rheumatology 1999; 38: 1113-1120
© 1999 British Society for Rheumatology
The occurrence of renal involvement in primary Sjögren's syndrome: a study of 78 patients
1 Departments of Internal Medicine and
2 Clinical Chemistry, Tampere University Hospital and
3 Medical School, University of Tampere, Tampere, Finland
Correspondence to:
M. Pertovaara, Department of Internal Medicine, Section of Rheumatology, Tampere University Hospital, PO Box 2000, FIN-33521 Tampere, Finland.
Objective.To ascertain the occurrence of renal involvement in patients with primary Sjögren's syndrome (pSS).
Methods.Urinary total protein excretion from 24 h urine collection, as well as urinary excretion rates of albumin, alpha-1 microglobulin (
1m) and IgG from overnight 8 h collections, were determined from 78 pSS patients (75 females, three males). Urine acidification capacity after oral ammonium chloride load was tested in 55 of these patients.
Results.Mild proteinuria (0.15–0.42 g/24 h) was observed in 34 patients (44%). Increased urinary excretion rates of albumin (
20 µg/min), 1m (7.0 µg/min) or IgG (5.0 µg/min) were detected in nine (12%), nine (12%) and 11 patients (14%), respectively. Latent or overt distal renal tubular acidosis (dRTA) was observed in 18 out of 55 patients with pSS (33%). These patients had a longer duration of the disease (10±4 vs 8±4 yr; P
0.05); they also had proteinuria (67 vs 27%; P0.025) and hypertension (44 vs 14%; P0.05) more frequently, and significantly higher serum creatinine (92±39 vs 78±13 µmol/l; P0.025) and serum beta-2 microglobulin (ß2m) levels (3.3±1.6 g/l vs 2.6±0.6 g/l; P0.025) as compared to patients with normal urine acidification capacity.
Conclusions.Inadequate renal acidification capacity, as well as mild proteinuria, were frequently found in patients with pSS. Those with dRTA had longer disease duration, a higher level of serum ß2m, and they had proteinuria and hypertension more frequently than those with normal renal acidification capacity.
KEY WORDS: Renal involvement, Sjögren's syndrome, Renal tubular acidosis, Proteinuria
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