Landry Claudia, Rodriguez-Calero Antonio, Vogt Bruno, Bocchi Federica
Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, Bern, Switzerland.
Institute of Tissue Medicine and Pathology, University of Bern, Bern, Switzerland.
Front Med (Lausanne). 2024 May 20;11:1379547. doi: 10.3389/fmed.2024.1379547. eCollection 2024.
Idiopathic nodular glomerulosclerosis (ING) is a rare condition characterized by poor renal prognosis. The pathophysiology remains incompletely understood. Histologically, it closely resembles diabetic nephropathy. The development of this disease seems to be influenced by factors such as metabolic syndrome, particularly hypertension and glucose intolerance, along with active smoking. We report a case of ING in an obese 71-year-old male patient who had a long history of untreated hypertension and smoking. The patient underwent conservative treatment involving the administration of an angiotensin-2 receptor antagonist and dapagliflozin, resulting in favorable disease progression. Additional therapeutic measures, such as discontinuation of smoking and efforts toward weight loss, are strongly advised. Furthermore, regular screening for diabetes in the follow-up is crucial, as it can play a pathophysiological role in the disease and may manifest at a later stage, as observed in our clinical case.
特发性结节性肾小球硬化症（ING）是一种罕见疾病，其特征是肾脏预后不良。其病理生理学仍未完全明确。在组织学上，它与糖尿病肾病极为相似。该疾病的发展似乎受到代谢综合征等因素的影响，特别是高血压和葡萄糖不耐受，以及主动吸烟。我们报告一例71岁肥胖男性ING患者，该患者有长期未治疗的高血压和吸烟史。患者接受了包括使用血管紧张素2受体拮抗剂和达格列净在内的保守治疗，疾病进展良好。强烈建议采取额外的治疗措施，如戒烟和努力减肥。此外，随访中定期筛查糖尿病至关重要，因为糖尿病在该疾病中可能起病理生理作用，并且可能在后期出现，正如我们临床病例中所观察到的那样。
