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肾痨:10例研究。发病率、自然史及相关病理学(作者译)

[Nephronophthisis: study of 10 cases. Incidence, natural history and associated pathology (author's transl)].

作者信息

Gómez Campderá F J, Niembro E, López Gómez J M, Canals M J, Bárcenas M C, Gómez J A, Rengel M A, Luque de Pablos A

出版信息

Med Clin (Barc). 1981 Oct 10;77(6):230-5.

PMID:7321636
Abstract

Nephronophthisis is a chronic interstitial nephropathy which in childhood may lead to terminal renal failure. Between January 1975 and July 1980, 41 children with terminal renal failure were seen in our service, of which 10 (21.9%) presented with nephronophthisis. Age of the patients ranged from 3.5-18 years, boys were in the majority (8/2). Three cases were isolated and 7 were familial (3 families). Onset was during the first year of life in 8 patients, and polydipsia-polyuria were the first symptoms. Retarded growth and anemia proportionate to the degree of renal failure were present in all patients. When diagnosed, 5 patients (50%) presented terminal renal failure, and the other 5 had renal failure of different degrees. Moderate proteinuria was found in 4 patients, without changes in urine sediment. Sodium depletion in urine was high in 5 cases and maximal urine osmolarity was less than 500 muOsm/l after hydropenia in all cases. Four had associated mental deficiency with cerebellar ataxia associated in two and congenital hepatic fibrosis (confirmed histologically) in one. The diagnosis was confirmed by biopsy in 8 and in two of these on frozen section during nephrectomy prior to kidney transplantation. At present, five of the patients are in maintenance hemodialysis, two died at home due to cardiovascular complications in terminal renal insufficiency and the remaining ones presented different degrees of renal insufficiency. Time elapsed between onset of the symptoms and inclusion in hemodialysis or death ranges form 6 months to 13 years (mean 6.7 years).

摘要

肾痨是一种慢性间质性肾病,在儿童期可导致终末期肾衰竭。1975年1月至1980年7月,我们科室共收治了41例终末期肾衰竭患儿,其中10例(21.9%)患有肾痨。患者年龄在3.5至18岁之间,以男孩居多(8例/2例)。3例为散发性,7例为家族性(3个家族)。8例患者在出生后第一年发病,多饮多尿为首发症状。所有患者均有生长发育迟缓及与肾衰竭程度相称的贫血。确诊时,5例患者(50%)已出现终末期肾衰竭,另外5例有不同程度的肾衰竭。4例患者有中度蛋白尿,尿沉渣无变化。5例患者尿钠排泄增加,所有患者在禁水后最大尿渗透压均小于500mOsm/l。4例患者伴有智力缺陷,2例伴有小脑共济失调,1例伴有先天性肝纤维化(经组织学证实)。8例患者经活检确诊,其中2例在肾移植前肾切除术中行冰冻切片检查确诊。目前,5例患者在维持性血液透析,2例因终末期肾功能不全的心血管并发症在家中死亡,其余患者有不同程度的肾功能不全。从症状出现到开始血液透析或死亡的时间为6个月至13年(平均6.7年)。

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[Nephronophthisis: study of 10 cases. Incidence, natural history and associated pathology (author's transl)].肾痨:10例研究。发病率、自然史及相关病理学(作者译)
Med Clin (Barc). 1981 Oct 10;77(6):230-5.
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