Sarcoidosis and the kidney: classical renal manifestations

Sarcoidosis possibly will involve the kidneys in several ways. Incidence and prevalence of renal involvement in sarcoidosis remain uncertain. Usually, aberrations of calcium metabolism include hypercalcemia, hypercalciuria, and nephrocalcinosis, are responsible for the renal manifestations of sarcoidosis. Granulomatous infiltration of the renal interstitium produces severe derangements of renal function. Glomerulonephritis can occur with sarcoidosis, although the pathogenesis remains unclear. Besides renal insufficiency and frank renal failure, nephrotic syndrome, nephrolithiasis, hypertension, and a variety of tubular defects may complicate sarcoidosis. The sensitivity of "sarcoid nephropathy" to corticosteroids usually warrants therapeutic trial. Our case is the first in the literature that demonstrates the renal-confined sarcoidosis. A 29 year male referred to nephrologist for Chronic kidney disease pancreatitis hypertension. During his examination patient had developed renal disease and hypercalcemia. Mild splenomegaly with bilateral increased parenchymal echotexture were seen Interestingly, NO inter bowel free fluid seen, NO gross congestive features identified. NO obstructive uropathy and NO hydronephrosis were seen. Renal insufficiency associated with sarcoidosis was subsequently attributed to renal infiltration by sarcoid granulomas. Despite the presence of sarcoid granuloma in 13% to 22% of kidneys surveyed, the granulomas were usually few in number, limited in extent, and rarely suspected of producing important renal functional impairment.