Shpigel' A N
Ter Arkh. 1991;63(6):126-31.
Analysis of the data obtained during a comprehensive examination of a great number of nephrologic patients during 1964-1989 permitted the author to draw a conclusion that a considerable part of errors in the diagnosis of diffuse renal lesions (DRL) are primarily made as a result of inadequate choice of examination methods that might contribute to the solving of a diagnostic problem; an insufficiently clear idea of the resolving power of those methods, and violation of the succession of their use. Erroneous interpretation of the patient's complaints and disease history we face sometimes, inadequate competence in the assessment of the clinical symptoms and laboratory data are of no less importance. All these moments are supported by the author's own observations. Special emphasis is laid on the causes of diagnostic errors occurring in the diagnosis of primary chronic pyelonephritis (PCPN), especially of its latent form, renal amyloidosis, focal nephritis, toxic or toxico-infectious kidneys, concomitant diffuse renal lesions, and on the etiology of the nephrotic syndrome (NS). The author substantiates inaccuracy of the concept of a potential development of the NS in patients suffering from PCPN. The author holds that if PCPN patients manifest the NS, it means that PCPN may be coupled with certain DRL complicated by the NS.
对1964年至1989年期间大量肾病患者进行全面检查所获得的数据进行分析后，作者得出结论：弥漫性肾损害（DRL）诊断中相当一部分错误主要是由于检查方法选择不当所致，这些方法本应有助于解决诊断问题；对这些方法的分辨能力认识不够清晰，以及违反了它们的使用顺序。我们有时会对患者的主诉和病史进行错误解读，对临床症状和实验室数据的评估能力不足也同样重要。所有这些情况都得到了作者自身观察结果的支持。特别强调了原发性慢性肾盂肾炎（PCPN），尤其是其潜伏形式、肾淀粉样变性、局灶性肾炎、中毒性或中毒感染性肾病、合并弥漫性肾损害的诊断中出现诊断错误的原因，以及肾病综合征（NS）的病因。作者证实了PCPN患者中NS潜在发展这一概念的不准确之处。作者认为，如果PCPN患者出现NS，这意味着PCPN可能与某些并发NS的DRL相关联。
