Renal involvement in primary Sjögren syndrome

Area of Science:

• Nephrology
• Rheumatology
• Autoimmunology

Background:

• Primary Sjögren syndrome (pSS) is an autoimmune condition affecting exocrine glands, leading to dry eyes and mouth.
• Renal involvement in pSS is uncommon (<10%), with tubulointerstitial nephritis (TIN) being the most frequent manifestation.
• TIN in pSS mirrors salivary gland pathology, involving plasma cell infiltration of the kidneys.

Purpose of the Study:

• To review the epidemiology, pathophysiology, diagnosis, and treatment of kidney disease in primary Sjögren syndrome.
• To highlight the importance of regular renal screening for early detection of complications in pSS patients.

Main Methods:

• Literature review of studies on renal manifestations in primary Sjögren syndrome.
• Analysis of epidemiological data, pathological findings, and clinical outcomes.

Main Results:

• Tubulointerstitial nephritis (TIN) is the predominant renal pathology in pSS, often associated with electrolyte disturbances.
• Glomerular involvement, such as membranoproliferative glomerulonephritis secondary to cryoglobulinaemia, is less common.
• While renal prognosis is generally favorable, TIN poses a significant risk for chronic kidney disease development.

Conclusions:

• Annual screening is recommended for early detection of renal complications in patients with systemic pSS.
• Understanding the spectrum of renal disease in pSS is crucial for timely diagnosis and management.
• Despite favorable outcomes, vigilance for chronic kidney disease in TIN patients is essential.