Tarantino A, Moroni G, Banfi G, Manzoni C, Segagni S, Ponticelli C
Division of Nephrology, Ospedale Maggiore IRCCS, Milano, Italy.
Nephrol Dial Transplant. 1994;9(10):1426-30.
Seventeen patients with nephritis due to mixed cryoglobulinaemia were submitted to regular haemodialysis in 11 and continuous ambulatory peritoneal dialysis in six after 145 +/- 55 months from the onset of the disease. Four patients with very poor clinical conditions died within 6 months from the beginning of dialysis. The other 13 patients were followed for a mean period of 78.7 +/- 41.6 months. The actuarial survival rate was 65% at 5 years. Both clinical and immunological signs of mixed cryoglobulinaemia reduced during dialysis but a long-lasting burn out was observed only in one patient. Two patients received a kidney graft. Mixed cryoglobulinaemia nephritis recurred in both of them respectively 5 and 10 months after transplantation. One patient lost his graft 13 months after transplantation because of chronic rejection. The other one still has a functioning kidney 48 months after renal transplantation. The life expectancy with dialysis for mixed cryoglobulinaemia patients is similar to that of patients with standard primary renal disease but some few patients with severe disease at the beginning of dialysis have a poor prognosis. Nephritis may recur after renal transplantation but this does not preclude per se a favourable course in the long term.
17例混合性冷球蛋白血症性肾炎患者在疾病发作145±55个月后，11例接受定期血液透析，6例接受持续性非卧床腹膜透析。4例临床状况极差的患者在透析开始后6个月内死亡。其余13例患者平均随访78.7±41.6个月。5年时的精算生存率为65%。混合性冷球蛋白血症的临床和免疫学指标在透析期间均有所减轻，但仅1例患者出现长期缓解。2例患者接受了肾移植。他们分别在移植后5个月和10个月出现混合性冷球蛋白血症性肾炎复发。1例患者在移植后13个月因慢性排斥反应失去了移植肾。另1例患者在肾移植后48个月移植肾仍功能良好。混合性冷球蛋白血症患者透析后的预期寿命与标准原发性肾病患者相似，但透析开始时少数病情严重的患者预后较差。肾移植后肾炎可能复发，但这本身并不排除长期的良好病程。
