From the Research
The treatment for Sjögren's Syndrome-associated Interstitial Nephritis primarily involves immunosuppressive therapy, with corticosteroids as the first-line treatment, and mycophenolate mofetil as a potential additional immunosuppressant for patients with severe disease or those who don't respond adequately to steroids, as evidenced by a study published in 2016 1.
Treatment Overview
The goal of treatment is to reduce the lymphocytic infiltration and inflammation in the kidneys, thereby improving kidney function and reducing morbidity and mortality.
- Corticosteroids, such as prednisone, are typically started at 0.5-1 mg/kg/day (usually 30-60 mg daily) for 2-4 weeks, followed by a gradual taper over several months based on clinical response.
- For patients with severe disease or those who don't respond adequately to steroids, additional immunosuppressants may be necessary, including mycophenolate mofetil (1-2 g/day in divided doses) 1.
Supportive Care
Supportive care is also essential, including:
- Maintaining adequate hydration
- Correcting electrolyte imbalances
- Managing blood pressure
- Regular monitoring of kidney function through blood tests (creatinine, BUN) and urinalysis is crucial during treatment.
Rationale for Treatment
The rationale for immunosuppressive therapy is to reduce the lymphocytic infiltration and inflammation in the kidneys that characterizes this condition, as Sjögren's Syndrome-associated Interstitial Nephritis results from autoimmune processes where the body's immune system attacks the renal tubules and interstitium, leading to kidney dysfunction. While other studies have reported the use of rituximab 2 and cyclophosphamide, the most recent and highest quality study recommends the use of mycophenolate mofetil as an additional immunosuppressant 1.