R. Rajakariar, E.J. Sharples, M.J. Raftery, M. Sheaff, M.M. Yaqoob

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Sarcoid tubulo-interstitial nephritis: Long-term outcome and response to corticosteroid therapy R. Rajakariar, E.J. Sharples, M.J. Raftery, M. Sheaff, M.M. Yaqoob Kidney International Volume 70, Issue 1, Pages 165-169 (July 2006) DOI: 10.1038/sj.ki.5001512 Copyright © 2006 International Society of Nephrology Terms and Conditions

Figure 1 The diagnostic breakdown of all patients referred to the Barts and the London Hospital renal unit with sarcoidosis and renal disease. * Patient presented with acute renal failure secondary to non-steroidal anti-inflammatory drugs which resolved on discontinuation of the drug hence a kidney biopsy was not performed. TIN: tubulo-interstitial nephritis; FSGS: primary focal segmental glomerulosclerosis; RPF: retroperitoneal fibrosis. Kidney International 2006 70, 165-169DOI: (10.1038/sj.ki.5001512) Copyright © 2006 International Society of Nephrology Terms and Conditions

Figure 2 Histological features of sarcoid TIN. (a) There is a diffuse lymphocytic infiltrate through the interstitium with evidence of interstitial scarring. (b) There is granuloma adjacent to a normal glomeruli. (c) The arrow points to an asteroid body an infrequent but classical feature of sarcoid TIN. Kidney International 2006 70, 165-169DOI: (10.1038/sj.ki.5001512) Copyright © 2006 International Society of Nephrology Terms and Conditions

Figure 3 Response to corticosteroid treatment. (a) Individual eGFRs at presentation and at 1 year in patients with sarcoid TIN. (b) Mean eGFR at presentation, 1 year and at last follow-up in the same group. The mean eGFR improved from 26.8±14 to 49.6±5.2 ml/min (P<0.01) at 1 year, and 47.9±6.8 ml/min (P<0.05) at last follow-up. Kidney International 2006 70, 165-169DOI: (10.1038/sj.ki.5001512) Copyright © 2006 International Society of Nephrology Terms and Conditions

Figure 4 Correlation of degree of fibrosis with response to treatment. The degree of tubular atrophy was determined and graded 0–3 (0, no fibrosis and 3, severe fibrosis) by three investigators blinded to the patient demographics and clinical presentation. Kidney International 2006 70, 165-169DOI: (10.1038/sj.ki.5001512) Copyright © 2006 International Society of Nephrology Terms and Conditions