Schwarting A, Märker-Hermann E
I. Medizinische Klinik und Poliklinik der Johannes-Gutenberg-Universität, 55101 Mainz, Germany.
Z Rheumatol. 2005 Feb;64(1):18-25. doi: 10.1007/s00393-005-0700-1.
Inflammatory rheumatic diseases are frequently complicated by subclinical or overt renal manifestations. This is well known for the connective tissue diseases and vasculitides in which renal disease can be of significant prognostic value and therapeutic implication. However, rheumatoid arthritis and the spondyloarthritides can also be associated with direct renal manifestation or with secondary renal AA-amyloidosis. The clinician should be aware of the different glomerular (i. e. nephritic or nephritic syndrome, rapidly progressive renal disease) and tubulo-interstitial syndromes. In any case of renal dysfunction in a rheumatic patient, the differential diagnosis should include renal disease independent from the rheumatic condition, infection, and drug-induced renal toxicity.
炎症性风湿性疾病常伴有亚临床或明显的肾脏表现。这在结缔组织病和血管炎中是众所周知的,其中肾脏疾病可能具有重要的预后价值和治疗意义。然而,类风湿关节炎和脊柱关节炎也可能与直接的肾脏表现或继发性肾脏AA淀粉样变性有关。临床医生应了解不同的肾小球(即肾炎或肾病综合征、快速进展性肾脏疾病)和肾小管间质综合征。对于风湿性患者出现的任何肾功能不全情况,鉴别诊断应包括与风湿性疾病无关的肾脏疾病、感染和药物性肾毒性。