Davran Ramazan, Helvaci Mehmet Rami, Davarci Mursel
Medical Faculty of The Mustafa Kemal University Antakya.
Int J Clin Exp Med. 2014 Jun 15;7(6):1603-6. eCollection 2014.
We tried to understand whether or not there is a higher risk of left renal atrophy in human being.
All patients applying to the Hematology Service with any underlying complaint were studied.
The study included 2,417 cases (1,248 females). The mean ages were 47.3 versus 50.7 years in females and males, respectively (p<0.000). There were 33 cases (1.3%) with the left renal atrophy against five cases (0.2%) with the right (p<0.001). The left renal atrophy cases have splenomegaly (SM) in 51.5%, thalassemia minors (TMs) in 30.3%, sickle cell diseases (SCDs) in 27.2%, myeloproliferative disorders in 18.1%, chronic lymphocytic leukemia in 6.0%, cirrhosis in 6.0%, solid organ malignancies in 6.0%, chronic obstructive pulmonary disease in 3.0%, multiple myeloma in 3.0%, and Waldenström's macroglobulinemia in 3.0%. Similarly, the right renal atrophy cases have SM in 20.0%, TMs in 40.0%, and SCDs in 20.0%.
Left renal atrophy may be significantly higher than the right side in human being. Aortic pressure induced flow disorders in the left renal vein, structural anomalies of the left renal vein, and possibly the higher arterial pressure of the left kidney due to the shorter distance to the heart as an underlying cause of atherosclerosis may be some of the possible causes. Due to the stronger arterial wall protecting itself from compression and high prevalences of SM and left varicocele in population, SM induced flow disorders of the left renal vein may be the most common cause.
我们试图了解人类左肾萎缩风险是否更高。
对所有因任何潜在病症前往血液科就诊的患者进行研究。
该研究纳入2417例患者(1248例女性)。女性和男性的平均年龄分别为47.3岁和50.7岁(p<0.000)。有33例(1.3%)出现左肾萎缩,而右肾萎缩有5例(0.2%)(p<0.001)。左肾萎缩病例中,51.5%有脾肿大(SM),30.3%有轻型地中海贫血(TMs),27.2%有镰状细胞病(SCDs),18.1%有骨髓增殖性疾病,6.0%有慢性淋巴细胞白血病,6.0%有肝硬化,6.0%有实体器官恶性肿瘤,3.0%有慢性阻塞性肺疾病,3.0%有多发性骨髓瘤,3.0%有华氏巨球蛋白血症。同样,右肾萎缩病例中,20.0%有SM,40.0%有TMs,20.0%有SCDs。
人类左肾萎缩可能显著高于右侧。左肾静脉中主动脉压力引起的血流紊乱、左肾静脉的结构异常,以及可能由于距离心脏较近导致左肾动脉压力较高而引发动脉粥样硬化,可能是一些潜在原因。由于动脉壁较强可保护自身免受压迫,且人群中SM和左侧精索静脉曲张患病率较高,SM引起的左肾静脉血流紊乱可能是最常见原因。