Chu Pei-Lun, Wei Yu-Feng, Huang Jenq-Wen, Chen Shih-I, Chu Tzong-Shinn, Wu Kwan-Dun
Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
Nephrology (Carlton). 2006 Aug;11(4):336-40. doi: 10.1111/j.1440-1797.2006.00586.x.
Renal infarction is usually an underestimated disease due to its rare and non-specific presentations; the renal survival of these patients is not well studied. The aim of the present analysis is to study the clinical features and outcome in patients who had documented renal infarction.
Twenty-two patients (12 men and 10 women, mean age of 57.7 +/- 3.44 years (28.4-83.3 years)) with image-confirmed segmental renal infarction in the past 15 years were enrolled. All patients were followed up at outpatient department with a median of 4 years (1-14 years). Initial and follow-up clinical characteristics and laboratory results were recorded.
The most common underlying disease was cardiovascular disease. Renal infarction often presented with non-specific symptoms, including flank pain (55%), vague abdominal pain (50%), nausea/vomiting (46%) and fever (27%). The levels of leucocytes, lactate dehydrogenase, blood urea nitrogen and serum creatinine were all elevated at admission. The early diagnosis group (12/22) had more obvious flank pain, nausea/vomiting (P < 0.001) and higher alanine transaminase (P = 0.02). It also predisposed to undergo antiplatelet or anticoagulant therapy (all P < 0.04). During follow up, there was no recurrence in the whole study group, and a trend of better recovery of renal function was noted in the early diagnosis group.
The serum creatinine level correlates with longer hospitalization length (P < 0.05). As regards long-term prognosis, no definite factor or treatment was found to have significant effect in segmental renal infarction patients. However, early diagnosis and early initiation of treatment seems to have a positive effect on future renal outcome.
肾梗死因其罕见且表现不具特异性，常为一种被低估的疾病；对这些患者的肾脏存活率尚未进行充分研究。本分析的目的是研究有记录的肾梗死患者的临床特征及预后。
纳入22例在过去15年内经影像学确诊为节段性肾梗死的患者（12例男性和10例女性，平均年龄57.7±3.44岁（28.4 - 83.3岁））。所有患者在门诊接受随访，中位随访时间为4年（1 - 14年）。记录初始及随访时的临床特征和实验室检查结果。
最常见的基础疾病是心血管疾病。肾梗死常表现为非特异性症状，包括侧腹痛（55%）、模糊的腹痛（50%）、恶心/呕吐（46%）和发热（27%）。入院时白细胞、乳酸脱氢酶、血尿素氮和血清肌酐水平均升高。早期诊断组（12/22）侧腹痛、恶心/呕吐更明显（P < 0.001），丙氨酸转氨酶更高（P = 0.02）。该组也更倾向于接受抗血小板或抗凝治疗（均P < 0.04）。随访期间，整个研究组无复发，早期诊断组肾功能有更好的恢复趋势。
血清肌酐水平与住院时间延长相关（P < 0.05）。关于长期预后，在节段性肾梗死患者中未发现明确的因素或治疗方法有显著影响。然而，早期诊断和早期开始治疗似乎对未来肾脏预后有积极影响。
