Women With Sarcoidosis at Increased Kidney Stone Risk, finds study

A new study published in the journal of Chest Pulmonary showed that nephrolithiasis is more common in Black women in the United States who have sarcoidosis.

Non-necrotizing granulomas are a hallmark of sarcoidosis that mostly affects the lungs and lymph nodes but can potentially result in severe extrapulmonary consequences. Although renal involvement is not well understood, it includes nephrolithiasis, chronic dysfunction, and acute kidney damage linked to hypercalcemia.

The overproduction of active vitamin D by granuloma-activated macrophages increases calcium absorption and encourages hypercalcemia and hypercalciuria, which may increase the risk of kidney stones. Black women in the US are disproportionately affected by sarcoidosis and have higher rates of metabolic risk factors for nephrolithiasis. This study calculates the correlation between kidney stone formation and sarcoidosis in this group.

Using information from the Black Women's Health Study (BWHS), which included 59,000 Black women in the United States between the ages of 21 and 69 in 1995 (baseline), this study performed a cross-sectional analysis. Baseline and biennial follow-up questionnaires were used to collect data on sarcoidosis and confounders until 2005. Nephrolithiasis diagnoses were determined with the 2005 questionnaire. Using logistic regression, they calculated ORs and 95% CIs while controlling for factors such as alcohol use, metabolic disorders (obesity, type 2 diabetes mellitus, hypertension, and hyperlipidemia), and calcium and vitamin D supplementation. 

43,718 women who answered the 2005 BWHS questionnaire made up the analytical sample. A total of 832 women reported having sarcoidosis between 1995 (the baseline) and 2005. In 2005, 3.9% of women with sarcoidosis and 1.9% of those without the disease reported having a history of nephrolithiasis.

Women with sarcoidosis had a 1.80 (95% CI, 1.25-2.59) chance of developing nephrolithiasis compared to those without the condition. For women with three to four co-occurring diseases, the correlation was further enhanced by the number of metabolic abnormalities (none, 1-2, and 3-4): 1.96 (95% CI, 1.09-3.52).

Overall, this study presents some of the first population-based risk estimates of the connection and shows that Black women who already have sarcoidosis may be more likely to acquire kidney stones. The results emphasize how crucial it is to keep an eye out for symptoms of calcium dysregulation when treating sarcoidosis.

Reference:

McAllister, T. R., Govender, P., Hicks, J. M., Wason, S. E. L., & Cozier, Y. C. (2025). Sarcoidosis and risk of nephrolithiasis in US Black women: Data from the Black Women’s Health Study. CHEST Pulmonary, 3(4), 100193. https://doi.org/10.1016/j.chpulm.2025.100193