Akhtar Sultan Zaffar, Ali Akhtar
Centre of Kidney Diseases, Hayatabad Medical Complex, PGMI, Peshawar, Pakistan.
J Ayub Med Coll Abbottabad. 2008 Oct-Dec;20(4):97-9.
Renal biopsy is a safe and informative technique that has played a key role in the evolution of nephrology as a specialty. This cross-sectional descriptive study was aimed to study the histological pattern of nephrotic syndrome in elderly patients.
This study was conducted from January 1998 to December 2005 (8 Years) in the Department of Nephrology, Govt. Lady Reading Hospital, Peshawar, Pakistan. We performed renal biopsy in 153 patients aged 60 years and above, admitted with nephrotic syndrome-proteinuria with protein > 3 gm/24 hours with or without oedema, hypoalbuminemia, hyperlipidemia, acute nephritic syndrome-red blood cell casts or dysmorphic red cells on urine microscopy, temporally associated with acute renal failure with or without new onset hypertension, acute renal failure-sudden decline in renal functions developing in days to weeks causing retention of nitrogenous wastes and rapidly progressive renal failure-sub acute decline in renal functions developing over weeks to months.
Significant differences in the histological pattern are noticed when compared with the studies of the other centres. Minimal Change Disease (MCD) was the commonest histological pattern (40%), followed by Membranous Nephropathy (21%), Crescentic Nephritis (19.6%), Focal Segmental Glomerulosclerosis (FSGS) (6.5%), Hypertensive Nephropathy (5.8%), Messangiocapillary Glomerulonephritis (MCGN) (3.9%) and Diffuse Proliferative Glomerulonephritis (DPGN) (3.2%).
肾活检是一种安全且能提供丰富信息的技术,在肾脏病学作为一门专业学科的发展过程中发挥了关键作用。这项横断面描述性研究旨在探讨老年患者肾病综合征的组织学模式。
本研究于1998年1月至2005年12月(8年)在巴基斯坦白沙瓦政府莱迪夫人医院肾病科进行。我们对153例60岁及以上因肾病综合征入院的患者进行了肾活检,这些患者蛋白尿蛋白>3克/24小时,伴有或不伴有水肿、低蛋白血症、高脂血症,急性肾炎综合征——尿显微镜检查可见红细胞管型或异形红细胞,与急性肾衰竭伴或不伴新发高血压在时间上相关,急性肾衰竭——肾功能在数天至数周内突然下降导致含氮废物潴留,以及快速进展性肾衰竭——肾功能在数周数月内亚急性下降。
与其他中心的研究相比,组织学模式存在显著差异。微小病变病(MCD)是最常见的组织学模式(40%),其次是膜性肾病(21%)、新月体性肾炎(19.6%)、局灶节段性肾小球硬化(FSGS)(6.5%)、高血压肾病(5.8%)、系膜毛细血管性肾小球肾炎(MCGN)(3.9%)和弥漫性增殖性肾小球肾炎(DPGN)(3.2%)。