Suzuki S, Arakawa M
Department of Medicine (II), Niigata University School of Medicine.
Nihon Ronen Igakkai Zasshi. 1991 May;28(3):311-7.
In order to clarify age-related changes in kidneys, the renal function and histological changes were evaluated in 962 patients with mild mesangial proliferative glomerulonephritis (Mes PGN) whose ages ranged from 7 to 82 years. The glomerular filtration rate (GFR) (Ccr), renal plasma flow (RPF) (CPAH) and PSP excretion rate were significantly lower in nephritic patients than in normal subjects. Age-related decreases of GFR, RPF, PSP excretion rate and maximal urine specific gravity in Fishberg concentration test were found in both groups. Serum levels of creatinine, urea nitrogen and uric acid were significantly higher in nephritic patients than in the normal population. Age-related increases of those parameters were found in both groups. The incidence of sclerotic glomeruli was almost same as that of the normal population estimated by Kaplan et al. The incidence of arterio- and arteriolosclerosis was also higher than that of normal subjects estimated by Bell. Thus, arterio- and arteriolosclerosis seems to be more age-dependent than glomerulosclerosis in patients with mild Mes PGN. In conclusion, renal functions decrease and renal arteriolar lesions increase gradually in proportion to aging. Mes PGN, even mild, can accelerate the physiological age-related decrease of renal function.
为了阐明肾脏的年龄相关变化,对962例年龄在7至82岁之间的轻度系膜增生性肾小球肾炎(Mes PGN)患者的肾功能和组织学变化进行了评估。肾炎患者的肾小球滤过率(GFR)(肌酐清除率)、肾血浆流量(RPF)(对氨基马尿酸清除率)和酚红排泄率显著低于正常受试者。两组均发现GFR、RPF、酚红排泄率和Fishberg浓缩试验中最大尿比重随年龄下降。肾炎患者血清肌酐、尿素氮和尿酸水平显著高于正常人群。两组均发现这些参数随年龄增加。硬化肾小球的发生率与Kaplan等人估计的正常人群发生率几乎相同。动脉和小动脉硬化的发生率也高于Bell估计的正常受试者。因此,在轻度Mes PGN患者中,动脉和小动脉硬化似乎比肾小球硬化更依赖年龄。总之,肾功能随年龄增长逐渐下降,肾小动脉病变逐渐增加。即使是轻度的Mes PGN也会加速与年龄相关的肾功能生理性下降。