Primary Sjogren's Syndrome may affect the kidneys but usually this is subclinical. Occasionally a patient may show signs of renal involvement. Goules et al listed screening criteria for identifying renal disease a patient with primary Sjogren's syndrome.


Renal abnormalities in Sjogren's syndrome:

(1) interstitial nephritis with or without renal tubular acidosis

(2) glomerulonephritis secondary to immune complex deposits

(3) Fanconi's syndrome



(1) presence of Sjogren's syndrome with xerostomia and xerophthalmia

(2) evidence of renal disease

(3) exclusion of other causes for the renal disease


Evidence of renal disease:

(1) elevated serum creatinine (> 1.6 mg/dL) with decreased creatinine clearance (< 50 mL per minute)

(2) persistent proteinuria (> 500 mg per 24 hours) for more than 3 months

(3) more than 10 RBCs per high power field or red blood cell casts in the renal sediment

(4) persistent low urine specific gravity (< 1.010) after 12 hours water deprivation AND persistent alkaline urine (pH > 7.0) for more than 6 months

(5) recurrent renal colic with urolithiasis or nephrocalcinosis

(6) Fanconi's syndrome without any other identifiable cause


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