单侧肾切除病人留存肾的功能储备

RENAL FUNCTION RESERVE IN PATIENTS AFTER UNILATERAL NEPHRECTOMY

目的 :研究肾切除病人的肾功能储备 ,确定有无肾脏高滤过损伤。方法 :17例单侧肾切除病人 ,男 10例 ,女 7例。年龄 30～ 6 4岁 ,平均 4 9岁。术后时间 1～ 13年 ,平均 4 .2年。肾肿瘤 9例 ,肾结核 5例 ,其他 3例。以 15例相应年龄之无肾脏病住院病人作对照。测定基础肌酐清除率 (Ccr)及蛋白质负荷后的Ccr,两组间进行肾脏滤过能力和肾功能储备的对比。结果 :两组蛋白质负荷试验后Ccr均显著高于基础Ccr ,肾切除病人肾脏滤过能力和肾功能储备显著低于对照组。结论 :单侧肾切除病人仍有一定肾功能储备 ,不存在肾脏高滤过损伤 。

Objective:To establish the renal filtration capacity and renal function reserve of patients who underwent unilateral nephrectomy. Methods:Seventeen patients after unilateral nephrectomy were included in the trial. A group of 15 healthy normal subjects with 2 kidneys served as contrls. We determined the creatinine clearance rate (Ccr) before and after protein load; the Ccr after protein load was renal filtration capacity; the Ccr difference befroe and after protein load was renal function reserve . Results: The volume of Ccr(ml/s/1.73m 2) before and after protein load and renal function reserve were 1.70±0.11,2.18±0.18,0.47±0.07 in control group and 1.35±0.12,1.57± 0.17 ,0.23±0.06 in nephrectomy group,and the renal filtration capacity of one kidney in control group was 1.09 . The difference of Ccr before and after protein load was significant in both control and nephrectomy group, the difference of renal function reserve and single kidney renal filtration capacity between control group and nephrectomy group were both signifcant. Conclusions:There is some renal function reserve in patients after unilateral nephrectomy but it decreases obviously, the renal infiltration capacity of single kidney is higher in nephrectomy patients than in normal subjects with 2 kidneys.