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Angiotensin-converting enzyme (ACE) reflects the presence of granuloma; accordingly, serum ACE (sACE) and tubular injury markers are measured in renal sarcoidosis (RS). However, these markers possess low diagnostic accuracy; therefore, we hypothesized that urinary ACE (uACE) could reflect granuloma in the kidneys and be a disease-specific marker for RS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center retrospective study, the sACE and uACE levels were measured and the creatinine-corrected ratio of uACE and sACE (u\/s ACE ratio) was calculated. Additionally, patients with sarcoidosis without renal insufficiency (RI), sarcoidosis with RI, and tubulointerstitial nephritis (TIN) without a sarcoidosis etiology were included as controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This study included 18, 18, 14, and 10 patients in the RS, sarcoidosis without RI, sarcoidosis with RI, and TIN without sarcoidosis etiology groups, respectively. uACE and u\/s ACE ratio in the RS group were higher than those in the control groups. In the RS group, u\/s ACE ratio was positively correlated with the degree of tubulointerstitial injury (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.69,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0045); the cutoff value of u\/s ACE ratio for diffuse tubulointerstitial injury was 0.39%, with a sensitivity and specificity of 100.0% each. Furthermore, obvious positive correlations were observed among u\/s ACE ratio, inflammatory cell infiltrates (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.53,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.044), and interstitial fibrosis (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.56,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.029) in the RS group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>u\/s ACE ratio and sACE could be useful biomarkers for diagnosing RS in sarcoidosis and TIN, respectively. A simple uACE assay could help diagnose and assess disease severity in patients with RS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10157-025-02803-8","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T06:58:49Z","timestamp":1770101929000},"page":"466-479","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Novel clinical application of urinary angiotensin-converting enzyme assay in renal sarcoidosis: a retrospective observational study"],"prefix":"10.1007","volume":"30","author":[{"given":"Yuki","family":"Chiba","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Murakami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariko","family":"Miyazaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Makino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mai","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tasuku","family":"Nagasawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsutomu","family":"Tamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuhiro","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7601-6557","authenticated-orcid":false,"given":"Koji","family":"Okamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"2803_CR1","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1164\/ajrccm.160.2.ats4-99","volume":"160","author":"Statement on Sarcoidosis","year":"1999","unstructured":"Statement on Sarcoidosis. 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