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经活检证实的肾病中三维超声检查的肾脏形态与肾脏病理结果及预后的关系。

Relationship of renal morphology on 3-dimensional ultrasonography with renal pathologic findings and outcome in biopsy-proven nephropathy.

作者信息

Xu Jianwei, Hwang Sung Il, Lee Hak Jong, Chin Ho Jun

机构信息

Department of Internal Medicine, 12303 Seoul National University Bundang Hospital, Seongnam, Gyeonggi 13620, Republic of Korea.

Department of Radiology, 12303 Seoul National University Bundang Hospital, Seongnam, Gyeonggi 13620, Republic of Korea.

出版信息

Exp Ther Med. 2018 Feb;15(2):2088-2096. doi: 10.3892/etm.2017.5626. Epub 2017 Dec 13.

Abstract

Kidney morphology has been used to estimate renal functions. The present study investigated the usefulness of kidney length and renal parenchymal volume (RPV) measured using three-dimensional ultrasonography (3-D USG) in estimating renal pathological findings, and the outcome in patients with nephropathy who underwent renal biopsy. In this study, 94 adult patients who had native kidney biopsy with 3-D USG results were included. The mean kidney length and RPV were independent factors of, and positively correlated to the estimated glomerular filtration rate (eGFR). The mean kidney length and RPV had inverse associations with the percentage of global glomerulosclerosis. Higher mean RPV, other than longer kidney length, indicated a lower prevalence of tubular atrophy. During 63.3±19.3 months of follow-up, a mean RPV of <125 ml increased the risk of composite outcome by 4.287 fold (95% confidence interval, 1.133-16.227) as compared with a mean RPV of ≥125 ml (P=0.032). In conclusion, kidney size was inversely associated with certain nephronal damage and positively associated with eGFR in nephropathy. Furthermore, smaller RPVs predicted worse outcomes of nephropathy.

摘要

肾脏形态已被用于评估肾功能。本研究调查了使用三维超声(3-D USG)测量的肾脏长度和肾实质体积(RPV)在评估肾脏病理结果方面的实用性,以及接受肾活检的肾病患者的预后情况。在本研究中,纳入了94例有3-D USG结果的接受自体肾活检的成年患者。平均肾脏长度和RPV是估计肾小球滤过率(eGFR)的独立因素,且与eGFR呈正相关。平均肾脏长度和RPV与全球肾小球硬化百分比呈负相关。除了肾脏长度较长外,较高的平均RPV表明肾小管萎缩的患病率较低。在63.3±19.3个月的随访期间,与平均RPV≥125 ml相比,平均RPV<125 ml使复合结局的风险增加了4.287倍(95%置信区间,1.133 - 16.227)(P = 0.032)。总之,在肾病中,肾脏大小与某些肾单位损伤呈负相关,与eGFR呈正相关。此外,较小的RPV预示着肾病的预后更差。

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