Jain A, et al. - In patients with primary Sjogren’s syndrome (pSS), the variety of clinical and subclinical renal involvement was assessed. They screened 174 patients and performed renal function tests, urine examination, renal ultrasound, arterial blood gases, urine pH followed by urine acidification test, and renal biopsy (if indicated) on 70 patients with pSS. Alkali replacement and oral prednisolone were used to treat renal tubular acidosis (RTA) and moderate–severe tubulointerstitial nephritis (TIN), respectively. One-year follow-up was completed in 62 patients. Findings showed an under-recognized renal involvement in pSS, most commonly manifested as RTA presenting with hypokalemic paralysis. These patients were younger with less articular and sicca symptoms. A possibility of subclinical RTA progressing to complete RTA was also noted. Considering renal biopsy in all patients with renal involvement was recommended.