el-Khatib M T, Becker G J, Kincaid-Smith P S
Department of Nephrology, Royal Melbourne Hospital, Australia.
Q J Med. 1990 Dec;77(284):1241-53. doi: 10.1093/qjmed/77.3.1241.
We have studied the clinical features and course of adults with reflex nephropathy and/or primary vesicoureteric reflux, paying particular attention to the differences between males and females, and the presenting features that influence prognosis. In our series of 293 patients, females outnumbered males in the ratio 5:1 and most presented with urinary infection, whereas males most commonly presented with features of renal damage such as proteinuria, hypertension or renal failure. Males more commonly had bilateral scarring and persistent reflux. One hundred and forty-seven patients were followed for two years or more (range 2-19 years); deterioration in renal function occurred in 55 (37 per cent). Risk factors for a rise in plasma creatinine were, in descending order, the presence of proteinuria, an elevated plasma creatinine concentration, bilateral scarring, male sex and the presence of hypertension. Stepwise multiple regression analysis showed that the independent risk factors were proteinuria, elevated plasma creatinine concentration and hypertension; gender and the presence of persistent reflux had no independent influence on the course of renal failure.
我们研究了患有反射性肾病和/或原发性膀胱输尿管反流的成年人的临床特征及病程，特别关注了男性与女性之间的差异以及影响预后的临床表现。在我们的293例患者系列中，女性与男性的比例为5:1，大多数女性表现为泌尿系统感染，而男性最常见的表现是肾损害特征，如蛋白尿、高血压或肾衰竭。男性更常出现双侧瘢痕形成和持续性反流。147例患者随访了两年或更长时间（范围为2至19年）；55例（37%）出现肾功能恶化。血浆肌酐升高的危险因素按降序排列依次为蛋白尿、血浆肌酐浓度升高、双侧瘢痕形成、男性以及高血压。逐步多元回归分析表明，独立危险因素为蛋白尿、血浆肌酐浓度升高和高血压；性别及持续性反流的存在对肾衰竭病程无独立影响。
