高龄患者肾小球疾病的病理形态及临床特点

The histological and clinical features in the elderly with renal disease

本文回顾性分析223例高龄肾脏病患者肾脏病变的病理分型及临床特点。其中原发性肾炎占65.5%;各类继发性肾脏病占34.5%,且随着年龄增长,继发性肾脏病的发病率逐渐增加。原发性肾炎中,以膜性肾病最常见;继发性者则以糖尿病、肾淀粉样变性多见。近年来,高龄患者中急性间质性肾炎及坏死性血管炎有所增多.肾病综合征及持续性尿检异常是最常见的初发临床表现,ARF的发病率有所升高。与青年人相比,高龄患者存在明显的肾小管-间质受损害的实验室及病理改变证据。

223 patients, aged 50～71 years, were biopsied because of a history of renal disease. All of these patients, the incidence of primary glomerulonephritis is about 65.5%, secondary renal disease is 34.5%. In a comparison with patients of younger age groups, it appeared that membranous nephropathy was the most commonly primary glomerulonephritis, the diabetes, amyloidosis had a significantly higher incidence in secondary glomerulonephritis in the elderly. Main clinical features were nephrotic syndrome (37.7%) and persistent proteinuria and hematuria (36.8%). In conclusion, we feel renal biopsy in the elderly is essential for the diagnosis and management of some clinical situations,such as acute renal failure and nephrotic syndrome.