Clinical Analysis Of Renal Involvement In Primary Sjogren’s Syndrome

Objective:The clinical,biochemical and immunological characteristics of primary Sjogren’s Syndrome(pSS)patients with and without renal damage were retrospectively analyzed to identify and evaluate the high risk factors for renal involvement in pSS.Methods:A total of 1002 pSS patients from the second affiliated hospital of shanxi medical university were included in this study(all of whom met the 2002 pSS diagnostic criteria).The clinical,biochemical and immunological characteristics of patients with or without renal involvement of pSS were compared by independent sample t test or chi-square test.Variables with P < 0.05 in the results were analyzed by logistic regression.P < 0.05 was considered as statistically significant.ROC curves of individual and joint indicators were plotted and the area under the curve was calculated.Results:A total of 1,002 patients with pSS were enrolled,including 840(83.83%)patients with non-renal impairment and 162(16.17%)patients with renal impairment,including929 females and 73 males.The average age of first visit was 52.5 years and the average course of illness was 5.6 years.Patients with renal involvement of pSS present with glandular symptoms(dry mouth and dry eyes)and extra-glandular symptoms(digestive,respiratory,and renal system involvement).The comparison between the two groups showed that the clinical manifestations were asthenia,edema of lower limbs anddigestive system symptoms with statistical significance.In laboratory examination,urinary erythrocytes,serum chlorine,creatinine,cystatin C and serum α1-MG(α1-microglobulin)were statistically significant(P < 0.05).The 12 renal biopsy results included 6 cases of interstitial nephritis,3 cases of mesangial glomerulonephritis,3 cases of membranous glomerulonephritis,1 case of diabetic nephropathy and 1 case of IgA nephropathy.ROC curve was drawn for creatinine,cystatin C and serum α1-MG,and the area under the curve was calculated.The results showed that the area under the curve of creatinine + cystatin C+ serum α1-MG and serum creatinine + serum α1-MG were significantly higher than that of creatinine,and the area under the curve of creatinine +serum α1-MG was the largest.Conclusion:Renal involvement is very common in pSS patients,and creatinine combined with serum α1-MG can be used as an evaluation index of renal impairment in pSS patients,which should be paid more attention in clinical practice.