Maher J F, Bryan C W, Ahearn D J
Arch Intern Med. 1975 Feb;135(2):273-8.
After serum creatinine levels exceeded 10mg/100ml, median survival was 55 days (to death or dialysis) in a group of 112 patients with chronic renal disease. Renal failure was partially reversible in 29 patients, partially accounting for prolonged survival. Those with polycystic kidneys, pyelonephritis, or obstructive nephropathy survived longer,partially because of more frequent reversibility and a slower increase in serum creatinine concentration. Kiabetic nephropathy, myelomatous kidneys, and amyloidosis were associated with shorter survival, less frequent reversibility, and more rapid progression. Urinary infection and extracellular volume depletion often accounted for partially reversible renal failure and prolonged survival. Blood pressure and age were not prognostic variables, while coexistent heart failure shortened survival. Survival correlated significantly with sodium excretion.
血清肌酐水平超过10mg/100ml后,112例慢性肾病患者的中位生存期为55天(至死亡或透析)。29例患者的肾衰竭部分可逆,这部分解释了生存期的延长。多囊肾、肾盂肾炎或梗阻性肾病患者生存期较长,部分原因是可逆性更常见且血清肌酐浓度升高较慢。糖尿病肾病、骨髓瘤肾病和淀粉样变性与生存期较短、可逆性较少及进展较快有关。尿路感染和细胞外液量减少常导致部分可逆性肾衰竭和生存期延长。血压和年龄不是预后变量,而并存的心力衰竭会缩短生存期。生存期与钠排泄显著相关。