原发性肾病综合征并发急性肾功能衰竭

Acute Renal Failure in Idiopathic Nephrotic Syndrome

目的 研究原发性肾病综合征 (DNS)并发急性肾功能衰竭 (ARF)的病因、临床及病理特征、治疗和预后。方法 3 8例患者均详细询问病史、检查尿蛋白定量、生化指标、血流变学、肾活组织病理检查。结果 发病年龄多在 40岁以下 ,占 82 % ,男性占76 3 % ,非少尿型 2 8例 ,占 74% ,肾活检示微小病变 2 0例 ,占 5 2 6% ,多数病例有不同程度肾间质水肿 ,予标准剂量激素 ,对症治疗 ,必要时透析 ,取得满意疗效。结论 DNS合并ARF ,病理以微小病变多见 ,病因多为血容量不足 ,而发生ARF ,多为非少尿型 ,经常规激素、对症及透析治疗 ,肾功能常可好转 。

Objective To study clinical feature,pathology,treatment and outcome of acute renal failure(ARF) in idiopathic nephrotic syndrome(IDNS).Methods History-taking of 38 cases were carried out all detailly 24-hour urine protein,biochemistry markers,hemorheology,renal histopathology were detected.Results The study fandings that 82 percent of patients were less than 40 years old,76 3 percent were male,74 percent(28 patients) were non-oliguria and 52 6 percent were minimal change glomerulonephritis through the renipuncture,most of the cases had edema of interstitium, by give prednisone of standard dosage,symptomatic treatment or dialysis the satisfying efficacy was got.Conclusions The main features of IDNS complicated with ARF are usual,it is non-oliguria type in clinic minimal glomerulonephritis in pathology,and deficient blood volume leads to occurrence of ARF,but the renal function could be recovered by give prednisone of routine dosage,symptomatic treatment and hemodialysis therapy.