Ratner M, Wüstenberg P, Serov V V, Rosenfeld B I, Warschavsky W A, Brodsky M A, Stenina I I, Nizze H, Sinn W, Schmicker R
Nephron. 1985;39(2):117-21. doi: 10.1159/000183354.
The tubular and tubulointerstitial renal functions of 237 patients with chronic glomerulonephritis and functional compensation corresponding to their plasma creatinine levels were investigated and the results were compared with the light microscopic findings obtained by examination of kidney interstices obtained by biopsy. Pronounced structural interstitial lesions (TiC) were found in 30% of the cases. Investigation of the predictive values of tubular function data in respect of the presence or exclusion of TiC showed that, although individual parameters of the renal function permit the exclusion of TiC disturbances with a high degree of certainty, the diagnostic value can be enhanced by considering pairs of such parameters. Five parameter combinations were found to have the highest predictive value regarding the diagnosis of TiC. These were disturbed concentration capacity accompanied by reduced ammonia excretion or total acid excretion, reduced water diuresis accompanied by disturbed ammonia excretion or total acid elimination; and, finally, the total acid excretion and maximum dilution capacity. The highest predictive values for the exclusion of TiC are shown by inconspicuous concentration capacity accompanied by normal ammonia excretion, total acid excretion, water diuresis, free water clearance or urine dilution capacity.
对237例慢性肾小球肾炎患者的肾小管及肾小管间质肾功能及其与血浆肌酐水平相对应的功能代偿情况进行了研究，并将结果与通过肾活检检查肾间质获得的光镜检查结果进行了比较。在30%的病例中发现了明显的结构性间质病变（TiC）。对肾小管功能数据在TiC存在或排除方面的预测价值进行研究表明，尽管肾功能的个别参数能够高度确定地排除TiC干扰，但通过考虑这些参数对可提高诊断价值。发现有五种参数组合对TiC诊断具有最高的预测价值。这些组合包括浓缩能力障碍伴氨排泄减少或总酸排泄减少、水利尿减少伴氨排泄或总酸消除障碍；最后是总酸排泄和最大稀释能力。排除TiC的最高预测价值表现为浓缩能力不明显且氨排泄、总酸排泄、水利尿、自由水清除率或尿液稀释能力正常。
