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[膜性肾小球肾炎。萨尔瓦多·苏比拉án国家营养研究所的经验]

[Membranous glomerulonephritis. Experience at the Instituto Nacional de la Nutrición Salvador Zubirán].

作者信息

Correa-Rotter R, Gamba G, Ochoa C, Onuma L, Reyes E, Tamayo J A, Peña J C

机构信息

Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de la Nutrición Salvador Zubirán, D.F. México.

出版信息

Rev Invest Clin. 1990 Apr-Jun;42(2):114-9.

PMID:2267443
Abstract

The purpose of this retrospective study was to study the incidence of idiopathic and secondary forms of membranous nephropathy in our institution, its clinical course and progression to chronic renal failure, and the risk factors associated with it. Two hundred fourteen (16%) of the 1,287 renal biopsies obtained between 1962 and 1988 were primary glomerular diseases and 28 of this 214 (13%) were idiopathic membranous nephropathy. On the other hand 59 of 1,287 biopsies were membranous nephropathy of whom 28 were idiopathic, 27 secondary to systemic lupus erythematosus, 2 due to drugs, one associated with rheumatoid arthritis, and one more with breast cancer. The clinical picture was: nephrotic syndrome in 84%, hypertension in 15%, non-nephrotic proteinuria in 14%, chronic renal failure in 8.4%, and renal vein thrombosis in 6.3%. In the idiopathic group 75% of the patients were male while in the lupus group 85% were female. For the analysis of progression to chronic renal failure we excluded 5 patients with renal failure when the biopsy was taken, 2 because the nephropathy was due to drugs, one associated with breast cancer, and nine were within the first year of follow-up. Thus, for this analysis the group consisted of 22 patients with idiopathic form and 20 with systemic lupus erythematosus. The idiopathic and lupus groups were similar except for a lower serum albumin in the former. The progression to renal failure was seen in 9 patients: six in the idiopathic group and the other 3 in the lupus group; this difference was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

这项回顾性研究的目的是探究我院特发性和继发性膜性肾病的发病率、临床病程及向慢性肾衰竭的进展情况,以及与之相关的危险因素。1962年至1988年间获取的1287份肾活检标本中,214份(16%)为原发性肾小球疾病,其中28份(13%)为特发性膜性肾病。另一方面,1287份活检标本中有59份为膜性肾病,其中28份为特发性,27份继发于系统性红斑狼疮,2份由药物引起,1份与类风湿关节炎相关,1份与乳腺癌相关。临床表现为:84%为肾病综合征,15%为高血压,14%为非肾病性蛋白尿,8.4%为慢性肾衰竭,6.3%为肾静脉血栓形成。特发性组中75%的患者为男性,而狼疮组中85%的患者为女性。为分析向慢性肾衰竭的进展情况,我们排除了活检时已患有肾衰竭的5例患者,2例因肾病由药物引起,1例与乳腺癌相关,9例在随访的第一年之内。因此,该分析的研究组包括22例特发性患者和20例系统性红斑狼疮患者。特发性组和狼疮组除前者血清白蛋白较低外,其他方面相似。9例患者进展为肾衰竭:特发性组6例,狼疮组3例;差异无统计学意义。(摘要截选至250字)

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