糖原贮积症Ⅰ型肾脏病变诊断及治疗进展

Advances on the management of renal lesion in glycogen storage disease type Ⅰ

糖原贮积症I型是一种糖原代谢异常疾病,由于肝、肾和小肠的葡萄糖-6-磷酸酶缺陷,导致肝大、低血糖、高乳酸血症、高脂血症、高尿酸血症、生长迟缓等。肾脏改变是其主要并发症之一,早期可表现为肾小球滤过率升高,后出现微量白蛋白尿以及肾小球滤过率下降和蛋白尿,可逐渐进展为肾间质纤维化、肾小球硬化,最终发展为肾衰竭。肾脏病变的早期发现和及时干预至关重要,现主要阐述糖原贮积症I型肾病的诊断和治疗进展。

Glycogen storage disease(GSD)is a group of congenital defects involved in the synthesis and decomposition of glycogen.As the most common type,GSD I is caused by mutations in glucose-6-phophate catalytic subunit(type Ia),or glucose-6-phosphate transporter(type Ib).Both defects can lead to hypoglycemia and accumulation of glycogen in the liver and kidney.So renal lesion is one of the main complications,which may manifest as increased glomerular filtration rate in the early stage,followed by microalbuminuria and decreased glomerular filtration rate and proteinuria.Subsequently it may progress into renal interstitial fibrosis,glomerulosclerosis,and eventually renal failure.Early detection and timely intervention of renal impairment are very important.Here we mainly describe the progress of diagnosis and treatment on the kidney disease of glycogen storage disease type I.