Nigam P, Pant K C, Kapoor K K, Kumar A, Saxena S P, Sharma S P, Mukhija R D, Gupta A K, Dubey A L
Indian J Lepr. 1986 Oct-Dec;58(4):567-75.
A study of 64 cases of leprosy (44 lepromatous and 20 nonlepromatous) revealed that the duration of the disease has a significant relationship with renal involvement (chi 2 = 16.9, P less than 0.001). Proteineuria, microscopic haematuria, granular and hyaline casts are mainly seen in lepromatous cases and specially with lepra reaction (100%) while few of the non-lepromatous (2%) cases may show these abnormalities. Impaired renal functions are mostly observed in lepromatous leprosy (62.9%) specially those with lepra reaction (100%) while 2% nonlepromatous cases have these impaired renal functions. Histo-pathological studies revealed non-specific changes in 44.4% of cases and those of chronic pyelonephritis in 15.5% of the cases. Renal amyloidosis is less common occurrence (4.4%). The specific lesion, that is 'leproma kidney', is rare and seen in one patient only. Acid fast bacilli could not be seen in any of the kidney tissue. It is therefore, concluded that the renal involvement in the form of inflammatory lesions and non-specific changes in the glomeruli and tubules are very common in lepromatous leprosy specially during the reactive phase.
一项对64例麻风病患者（44例瘤型和20例非瘤型）的研究表明，病程与肾脏受累情况存在显著关联（χ² = 16.9，P < 0.001）。蛋白尿、镜下血尿、颗粒管型和透明管型主要见于瘤型病例，特别是在麻风反应期（100%），而非瘤型病例中仅有少数（2%）可能出现这些异常。肾功能损害多见于瘤型麻风（62.9%），特别是伴有麻风反应的患者（100%），而非瘤型病例中仅有2%出现肾功能损害。组织病理学研究显示，44.4%的病例有非特异性改变，15.5%的病例有慢性肾盂肾炎改变。肾淀粉样变性较少见（4.4%）。特异性病变即“麻风肾”罕见，仅在1例患者中见到。在任何肾脏组织中均未发现抗酸杆菌。因此得出结论，在瘤型麻风，特别是反应期，以炎症性病变以及肾小球和肾小管非特异性改变形式出现的肾脏受累非常常见。
