Mallick N P
Department of Renal Medicine, Royal Infirmary, Manchester, UK.
Clin Nephrol. 1991;35 Suppl 1:S3-7.
The term "idiopathic nephrotic syndrome" is poorly defined and is used to refer to a variety of glomerular lesions. This article seeks to clarify the situation by considering the case for treating minimal-change nephropathy, focal and segmental glomerulosclerotic lesions, and mesangioproliferative lesions with predominantly IgM deposition as separate disease entities. In children, nephrotic syndrome has a pattern different from that in adults, in whom a wider pathogenetic spectrum is seen. There is support for the use of prospective clinicopathological data as the basis of identifying those patients with nephrotic syndrome who will progress to end-stage renal failure. Very heavy, persisting proteinuria is one marker of such progression and is also an indicator of metabolic complications, such as cardiovascular disease, which further increase the risks of mortality and morbidity in this group of patients.
“特发性肾病综合征”这一术语定义不明确，用于指代多种肾小球病变。本文旨在通过将微小病变性肾病、局灶节段性肾小球硬化性病变以及以IgM沉积为主的系膜增生性病变作为独立的疾病实体来考虑治疗情况，从而澄清这一局面。在儿童中，肾病综合征的模式与成人不同，成人中可见更广泛的致病谱。有证据支持以前瞻性临床病理数据为基础，来识别那些将进展至终末期肾衰竭的肾病综合征患者。非常严重且持续的蛋白尿是这种进展的一个标志，也是代谢并发症（如心血管疾病）的一个指标，这进一步增加了该组患者的死亡和发病风险。
