Coward R A, Hamdy N A, Shortland J S, Brown C B
Nephrol Dial Transplant. 1986;1(1):31-7.
A 10-year retrospective study of 36 patients is presented; the patients comprised 27 with renal micropolyarteritis nodosa (microPAN) and nine with Wegener's granulomatosis. At presentation, 29 patients had significant renal impairment (creatinine greater than 150 mumol/l), with 18 requiring dialysis at some time during their illness. Eighteen patients showed rapid recovery of renal function, a further two with apparently chronic renal failure recovered renal function after 4 months dialysis and continued immunosuppression. Seven patients required chronic dialysis. No benefit was shown for any particular immunosuppressive regime, with three patients recovering renal function (two initially on dialysis) without any immunosuppression. Prognosis was better than in previous published series, especially considering the elderly population (mean 52.9 years), with an 80% 1-year and a 64% 5-year survival.
本文呈现了一项对36例患者的10年回顾性研究;其中27例为肾微小动脉炎结节病(微结节性多动脉炎),9例为韦格纳肉芽肿病。就诊时,29例患者存在严重肾功能损害(肌酐大于150μmol/L),其中18例在病程中某个阶段需要透析治疗。18例患者肾功能迅速恢复,另外2例明显为慢性肾衰竭的患者在透析4个月并持续免疫抑制治疗后肾功能恢复。7例患者需要长期透析。未显示任何特定免疫抑制方案有优势,3例患者未接受任何免疫抑制治疗肾功能恢复(2例最初接受透析)。预后优于以往发表的系列研究,尤其是考虑到老年人群(平均52.9岁),1年生存率为80%,5年生存率为64%。