Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN, USA.
J Vet Intern Med. 2011 Mar-Apr;25(2):206-14. doi: 10.1111/j.1939-1676.2010.0669.x. Epub 2011 Jan 31.
Nephrotic syndrome (NS) develops most commonly in people with glomerular diseases associated with marked albuminuria. Hypernatremia, hypertension, and progressive renal failure are more prevalent in nephrotic than nonnephrotic human patients.
HYPOTHESIS/OBJECTIVES: Dogs with NS have higher serum cholesterol, triglyceride, and sodium concentrations, higher urine protein:creatinine ratios (UPC) and systolic blood pressure, and lower serum albumin concentrations than dogs with nonnephrotic glomerular disease (NNGD). NS is associated with membranous glomerulopathy and amyloidosis. Affected dogs are more likely to be azotemic and have shorter survival times.
Two hundred and thirty-four pet dogs (78 NS dogs, 156 NNGD dogs).
Multicenter retrospective case-control study comparing time-matched NS and NNGD dogs. NS was defined as the concurrent presence of hypoalbuminemia, hypercholesterolemia, proteinuria, and extravascular fluid accumulation. Signalment, clinicopathologic variables, histopathologic diagnoses, and survival time were compared between groups.
Age, serum albumin, chloride, calcium, phosphate, creatinine, and cholesterol concentrations, and UPC differed significantly between NS and NNGD dogs. Both groups were equally likely to be azotemic at time of diagnosis, and NS was not associated with histologic diagnosis. Median survival was significantly shorter for NS (12.5 days) versus NNGD dogs (104.5 days). When subgrouped based on serum creatinine (< or ≥1.5 mg/dL), survival of NS versus NNGD dogs was only significantly different in nonazotemic dogs (51 versus 605 days, respectively).
Presence of NS is associated with poorer prognosis in dogs with nonazotemic glomerular disease. Preventing development of NS is warranted; however, specific interventions were not evaluated in this study.
肾病综合征（NS）最常发生在伴有大量白蛋白尿的肾小球疾病患者中。高钠血症、高血压和进行性肾衰竭在肾病患者中比非肾病患者更为常见。
假说/目的：患有 NS 的犬的血清胆固醇、甘油三酯和钠浓度较高，尿蛋白/肌酐比值（UPC）和收缩压较高，血清白蛋白浓度较低，而非肾病性肾小球疾病（NNGD）犬。NS 与膜性肾小球病和淀粉样变性有关。受影响的犬更容易出现氮血症，生存时间更短。
234 只宠物犬（78 只 NS 犬，156 只 NNGD 犬）。
多中心回顾性病例对照研究比较了时间匹配的 NS 和 NNGD 犬。NS 被定义为同时存在低白蛋白血症、高胆固醇血症、蛋白尿和血管外液积聚。比较两组间的特征、临床病理变量、组织病理学诊断和生存时间。
年龄、血清白蛋白、氯、钙、磷、肌酐和胆固醇浓度以及 UPC 在 NS 和 NNGD 犬之间有显著差异。两组在诊断时均有同样可能出现氮血症，且 NS 与组织学诊断无关。NS 犬的中位生存期明显短于 NNGD 犬（12.5 天对 104.5 天）。根据血清肌酐（<或≥1.5mg/dL）进行亚组分析时，非氮血症 NS 犬与 NNGD 犬的生存时间差异仅具有统计学意义（分别为 51 天和 605 天）。
在非氮血症性肾小球疾病犬中，存在 NS 与预后较差相关。有必要预防 NS 的发生；然而，本研究未评估特定的干预措施。
