Jinde Kiichiro, Endoh Masayuki, Sakai Hideto
Division of Nephrology and Metabolism, Internal Medicine, Tokai Univ. School of Medicine, Isehara, Kanagawa.
Rinsho Byori. 2003 Mar;51(3):214-8.
In chronic glomerular nephritis (CGN), it is important to estimate the renal function and 24 hr urinary protein excretion to estimate the effectiveness of the treatment. In this study, we evaluated the usefulness of a microscopic urine test in making pathological diagnosis. As a result, we found that IgA nephritis has a significantly higher urinary RBC count among the CGN group, and found focal glomerular sclerosis and membranoproliferatine GN patients have significantly higher urinary RBC count among nephrotic patients. Among patients who have moderate renal insufficiency, acute tubular necrosis and acute interstitial nephritis have higher levels in urinary RBC counting. In summary, we can estimate the pathology of renal diseases by microscopic urinary tests to a certain extent. In western countries, physician have used the Cockcroft and Gault formula to estimate creatinine clearance, and they also have used urine protein-to-creatinine ratio to estimate 24 hr urinary protein excretion. We evaluated these formulae with Japanese, and as a result, found lower estimation of creatinine clearance and urinary protein excretion, which may be due to lower their muscle mass. We need further evaluation to make suitable changes to these formulae for Japanese.
在慢性肾小球肾炎（CGN）中，评估肾功能和24小时尿蛋白排泄量对于评估治疗效果很重要。在本研究中，我们评估了显微镜尿检在病理诊断中的实用性。结果，我们发现在CGN组中IgA肾病的尿红细胞计数显著更高，并且发现局灶性肾小球硬化和膜增生性肾小球肾炎患者在肾病患者中尿红细胞计数显著更高。在有中度肾功能不全的患者中，急性肾小管坏死和急性间质性肾炎的尿红细胞计数更高。总之，我们可以通过显微镜尿检在一定程度上估计肾脏疾病的病理情况。在西方国家，医生使用Cockcroft和Gault公式来估计肌酐清除率，他们还使用尿蛋白与肌酐比值来估计24小时尿蛋白排泄量。我们用日本人的数据评估了这些公式，结果发现对肌酐清除率和尿蛋白排泄量的估计较低，这可能是由于他们的肌肉量较低。我们需要进一步评估，以便对这些公式进行适当修改以适用于日本人。
