论文部分内容阅读
目的探讨原发性肾病综合征(PNS)并发特发性急性肾功能衰竭(IARF)的临床病理特点、治疗方法及预后。方法回顾分析358例PNS中并发IARF的23例患者的临床病理特点、治疗方法及预后情况。结果IARF发生率为6.4%,23例患者均出现大量蛋白尿及低蛋白血症,血肌酐、尿素氮进行性升高,肾活检病理检查示微小病变肾病13例(56.4%),系膜增生性肾炎3例(13.1%),其共同病理变化是小管间质病变广泛。经泼尼松、速尿和环磷酰胺及血液透析等综合治疗后,91.7%的患者肾功能完全恢复正常。结论IARF以肾小球轻微病变多见,早期综合治疗,其预后较好。
Objective To investigate the clinicopathological characteristics, treatment and prognosis of idiopathic nephrotic syndrome (PNS) complicated with idiopathic acute renal failure (IARF). Methods The clinical pathological features, treatment and prognosis of 23 patients with PNS complicated by IARF were retrospectively analyzed. Results The incidence of IARF was 6.4%. Thirty-three patients developed massive proteinuria and hypoalbuminemia. Serum creatinine and urea nitrogen increased progressively. Pathological examination of renal biopsy revealed 13 cases of minimal change nephropathy (56.4%), mesangial proliferation 3 cases of nephritis (13.1%), the common pathological changes are extensive tubulointerstitial lesions. After prednisone, furosemide and cyclophosphamide and hemodialysis and other comprehensive treatment, 91.7% of patients with complete renal function returned to normal. Conclusion IARF is more common in mild glomerular lesions, early comprehensive treatment, the prognosis is good.