老年慢性肾功不全的病理特点

Pathological Characteristics ofChronic Renal insufficiency in Elderly

从４０年间１０００例老年尸检中选肾损害有明确病理诊断的病例２８８例，男性１６５例、女性１２３例，年龄６０～９５岁，平均７２．７６岁。结果：１、肾功损害程度与死因关系：（１）尚能代偿，非直接死于肾疾病者１８４例；（２）失代偿期，出现慢性肾衰，肾疾病是死因之一者６０例；（３）终末期肾，直接死于尿毒症者４４例。２、常见慢性肾功不全的肾疾病分类：（１）肾血管为主肾疾病１１８例（４１％）；（２）肾实质小球改变为主肾疾病７６例（２６．５％）；（３）肾小管及肾间质为主肾疾病７１例（２４．５％）；（４）尿道肿瘤及畸形２３例（８％）．３、慢性肾功不全的病理：肾体积、肾重量减少，肾小球透明变，电镜上皮细胞足突消失，基底膜有电子高密度沉积物，肾小管坏死，间质纤维化等改变。

We interviewed 288 cases with definitepathological dignosis of renal demage from1000 elderly autopsies in the past 40 years(165 cases were female, 123 cases weremale,the average age was 72. 2 years old).The results showed that:l.the relationsbetween the degrees of renal demage andthe causes of death;(l)still compensatary,184 patients didn't die of renal diseases;(2)uncompensatary phase,chronic renal failurewas one of the causes of death in 60 cases;(3) end-stage kidney,44 patients died ofuremia.2.the classification of chronic renalfailure:(1) 118 cases with diseased renalvessles:(2) 76 cases with glomerulusdemages; (33)71 cases with disfunction of re-nal tubules and medulla nephrica;(4).23cases with urinary tract tumor and deformi-ty. 3.Pathology of chronic renal insufficien-cy:decreased volume and weight of the kidney; glomerulus hyalinosis;disappearance ofpodocytic process of epithelial cell;base-ment membrane with high density of sub-stances under the electronic microscope: re-nal tubules necrosis, fibrosis of medullanephrica