Introduction: Primary Glomerular Diseases are a spectrum of renal disorders of unknown aetiology with distinct characteristics, specific natural history and prognosis. A thorough evaluation is prerequisite to establis...Introduction: Primary Glomerular Diseases are a spectrum of renal disorders of unknown aetiology with distinct characteristics, specific natural history and prognosis. A thorough evaluation is prerequisite to establish the diagnosis since many systemic diseases and secondary aetiology masquerade as primary diseases. Methods: This prospective observational study was conducted at a tertiary care centre and included 30 patients, with clinical features suggestive of primary glomerular diseases, of which 23 patients (76.6%) were males and 07 patients (23.33%) were females. The mean age at presentation was 37.23 ± 12.89 years. Among the observed spectrum of Primary Glomerular Diseases, IgA Nephropathy (IgA N) was seen in 26.67% patients, Focal Segmental Glomerulosclerosis (FSGS) in 20% patients and Membranous Glomerulopathy (MGN) in 13.33% patients, whereas the incidence of other abnormalities had less percentage contribution. Proteinuria was the commonest presentation seen in 60% patients, followed by Microscopic Haematuria in 20%. Mean Serum Creatinine was 0.99 ± 0.16 mg/dl. Mean Serum Albumin was 2.51 ± 0.76 gm/dl. Overall Nephrotic range proteinuria was observed in 15 (50%) patients. Results: IgA N, FSGS & MGN were the commonest observed Primary Glomerular Diseases. Proteinuria, Haematuria, Anasarca and Pedal Oedema were the commonest observed clinical presentations. Conclusions: In this studied series IgA Nephropathy, FSGS and MGN were the most prevelant diagnoses in the patients presenting with Urinary Abnormality. Nephrotic range Protenuria was the major indication for biopsy, there is a temporal variation in glomerulopathies wherein there is increase in incidence of IgA Nephropathy and decrease in incidence of FSGS.展开更多
BACKGROUND IgA nephropathy(IgAN)is a common primary glomerular disease that leads to end-stage renal disease with poor therapy efficacy.Traditional Chinese medicine(TCM)is effective in the treatment of IgAN and has th...BACKGROUND IgA nephropathy(IgAN)is a common primary glomerular disease that leads to end-stage renal disease with poor therapy efficacy.Traditional Chinese medicine(TCM)is effective in the treatment of IgAN and has the potential to become an alternative treatment for IgAN.Professor Yan-Qin Zou is a nephropathy expert,a National Chinese Medicine Master,and an heir to the Menghe School of Medicine.CASE SUMMARY A 28-year-old man had positive urinary protein and elevated serum creatinine(Scr)results and was diagnosed with IgAN 2-3 years prior to the outpatient department visit at our hospital in 2017.Professor Zou used the following methods to treat the patient:Invigorating the spleen and tonifying the kidney,removing dampness and clearing turbidity,quickening the blood and transforming stasis,and freeing vessels and regulating collaterals.She adjusted the prescription in accordance with the patient’s symptoms.After 6 mo of treatment,the symptoms had resolved and serological indexes were also decreased[Scr from 288.5 to 188.6μmol/L,blood urea nitrogen(BUN)from 10.9 to 9.5 mmol/L,serum uric acid(UA)from 612 to 503μmol/L].During follow-up,BUN,Scr,and UA levels remained stable.CONCLUSION Professor Zou’s therapeutic strategy to treat IgAN using TCM was efficacious and a good reference for application.展开更多
目的探讨尿IgG/尿肌酐(UGCR)、24 h尿蛋白定量(24 h UP)、尿蛋白定量/尿肌酐(UPCR)在预测IgA血管炎肾炎(IgAVN)患儿肾脏病理进展中的价值。方法选取2018年1月—2022年10月收治的IgAVN患儿234例,均采集24 h尿液标本检测24 h UP。根据肾...目的探讨尿IgG/尿肌酐(UGCR)、24 h尿蛋白定量(24 h UP)、尿蛋白定量/尿肌酐(UPCR)在预测IgA血管炎肾炎(IgAVN)患儿肾脏病理进展中的价值。方法选取2018年1月—2022年10月收治的IgAVN患儿234例,均采集24 h尿液标本检测24 h UP。根据肾小球损伤程度不同将IgAVN患儿分为Ⅱ级47例、Ⅲ级175例、Ⅳ级12例,分析UGCR、24 h UP、UPCR与肾脏病理分级的相关性,通过受试者工作特征曲线分析上述指标预测肾脏IgAVN病理分级进展为Ⅲ级及以上的价值。结果肾脏病理分级Ⅲ级、Ⅳ级患儿UGCR、24 h UP、UPCR水平高于Ⅱ级患儿(P<0.01)。UGCR、24 h UP、UPCR与病理分级呈正相关,但相关性较弱(r=0.500、0.451、0.356,P<0.01)。UGCR、24 h UP和UPCR对IgAVN患儿肾脏病理分级进展为Ⅲ级及以上均具有预测价值,且三者联合检测预测价值更高(曲线下面积>0.9,P<0.01)。结论UGCR联合24 h UP、UPCR对IgAVN肾脏病理分级进展为Ⅲ级及以上的预测价值更高。展开更多
文摘Introduction: Primary Glomerular Diseases are a spectrum of renal disorders of unknown aetiology with distinct characteristics, specific natural history and prognosis. A thorough evaluation is prerequisite to establish the diagnosis since many systemic diseases and secondary aetiology masquerade as primary diseases. Methods: This prospective observational study was conducted at a tertiary care centre and included 30 patients, with clinical features suggestive of primary glomerular diseases, of which 23 patients (76.6%) were males and 07 patients (23.33%) were females. The mean age at presentation was 37.23 ± 12.89 years. Among the observed spectrum of Primary Glomerular Diseases, IgA Nephropathy (IgA N) was seen in 26.67% patients, Focal Segmental Glomerulosclerosis (FSGS) in 20% patients and Membranous Glomerulopathy (MGN) in 13.33% patients, whereas the incidence of other abnormalities had less percentage contribution. Proteinuria was the commonest presentation seen in 60% patients, followed by Microscopic Haematuria in 20%. Mean Serum Creatinine was 0.99 ± 0.16 mg/dl. Mean Serum Albumin was 2.51 ± 0.76 gm/dl. Overall Nephrotic range proteinuria was observed in 15 (50%) patients. Results: IgA N, FSGS & MGN were the commonest observed Primary Glomerular Diseases. Proteinuria, Haematuria, Anasarca and Pedal Oedema were the commonest observed clinical presentations. Conclusions: In this studied series IgA Nephropathy, FSGS and MGN were the most prevelant diagnoses in the patients presenting with Urinary Abnormality. Nephrotic range Protenuria was the major indication for biopsy, there is a temporal variation in glomerulopathies wherein there is increase in incidence of IgA Nephropathy and decrease in incidence of FSGS.
基金Supported by Delaying the Progression of Renal Failure in Chronic Kidney Disease Project,No. JD2019SZ10Jiangsu Chinese Medicine Science and Technology Development Projects,No. YB201913
文摘BACKGROUND IgA nephropathy(IgAN)is a common primary glomerular disease that leads to end-stage renal disease with poor therapy efficacy.Traditional Chinese medicine(TCM)is effective in the treatment of IgAN and has the potential to become an alternative treatment for IgAN.Professor Yan-Qin Zou is a nephropathy expert,a National Chinese Medicine Master,and an heir to the Menghe School of Medicine.CASE SUMMARY A 28-year-old man had positive urinary protein and elevated serum creatinine(Scr)results and was diagnosed with IgAN 2-3 years prior to the outpatient department visit at our hospital in 2017.Professor Zou used the following methods to treat the patient:Invigorating the spleen and tonifying the kidney,removing dampness and clearing turbidity,quickening the blood and transforming stasis,and freeing vessels and regulating collaterals.She adjusted the prescription in accordance with the patient’s symptoms.After 6 mo of treatment,the symptoms had resolved and serological indexes were also decreased[Scr from 288.5 to 188.6μmol/L,blood urea nitrogen(BUN)from 10.9 to 9.5 mmol/L,serum uric acid(UA)from 612 to 503μmol/L].During follow-up,BUN,Scr,and UA levels remained stable.CONCLUSION Professor Zou’s therapeutic strategy to treat IgAN using TCM was efficacious and a good reference for application.
文摘目的探讨尿IgG/尿肌酐(UGCR)、24 h尿蛋白定量(24 h UP)、尿蛋白定量/尿肌酐(UPCR)在预测IgA血管炎肾炎(IgAVN)患儿肾脏病理进展中的价值。方法选取2018年1月—2022年10月收治的IgAVN患儿234例,均采集24 h尿液标本检测24 h UP。根据肾小球损伤程度不同将IgAVN患儿分为Ⅱ级47例、Ⅲ级175例、Ⅳ级12例,分析UGCR、24 h UP、UPCR与肾脏病理分级的相关性,通过受试者工作特征曲线分析上述指标预测肾脏IgAVN病理分级进展为Ⅲ级及以上的价值。结果肾脏病理分级Ⅲ级、Ⅳ级患儿UGCR、24 h UP、UPCR水平高于Ⅱ级患儿(P<0.01)。UGCR、24 h UP、UPCR与病理分级呈正相关,但相关性较弱(r=0.500、0.451、0.356,P<0.01)。UGCR、24 h UP和UPCR对IgAVN患儿肾脏病理分级进展为Ⅲ级及以上均具有预测价值,且三者联合检测预测价值更高(曲线下面积>0.9,P<0.01)。结论UGCR联合24 h UP、UPCR对IgAVN肾脏病理分级进展为Ⅲ级及以上的预测价值更高。
