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Q J Med 2000; 93: 297-304
© 2000 Association of Physicians

Renal involvement in primary Sjögren's syndrome

K. Aasarød, H.-J. Haga1, K.J. Berg2, J. Hammerstrøm and S. Jørstad

From the Department of Medicine, University Hospital of Trondheim 1 Center for Rheumatology, Haukeland University Hospital, Bergen, and 2 Laboratory for Renal Physiology, The National Hospital, Oslo, Norway

Received 21 December 1999 Renal involvement was evaluated in 62 patients with primary Sjögren's syndrome, classified according to criteria proposed by The European Classification Criteria Group. Urine concentration capacity was tested using intranasal 1-desamino-8-D-arginine-vasopressin. For patients with urine pH>5.5 without metabolic acidosis (n=28), an acidification test with ammonium chloride was performed. Urinary citrate, albumin, NAG, ALP and ß2-microglobulin were measured and creatinine clearance was calculated. Maximum urine concentration capacity and creatinine clearance were reduced in 13 (21%). Albumin excretion was >30 µg/min in only one patient (1.6%). Seven patients (11.3%) had complete or incomplete distal renal tubular acidosis (dRTA), four had reduced creatinine clearance and five had reduced maximum urine concentration capacity. The ratio of citrate/creatinine in spot urine was below the 2.5 percentile in all patients with complete or incomplete dRTA. The prevalence of dRTA was lower than in previous studies. There were also few patients with signs of glomerular disease (1.6%). The use of citrate:creatinine ratio in spot urine can be a helpful method in identifying patients with complete or incomplete dRTA.

Address correspondence to Dr K. Aasarød, Department of Medicine, University Hospital of Trondheim, Olav Kyrres gate 17, N-7006 Trondheim, Norway. e-mail: knut.aasarod{at}medisin.ntnu.no


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