Nakano M, Hasegawa H, Watanabe T, Kuroda T, Ito S, Saeki T, Ueno M, Ozawa T, Kikuchi M, Sato T
Department of Medicine (II), Niigata University School of Medicine.
Ryumachi. 1994 Aug;34(4):725-32.
This study was designed to evaluate the clinical significance of glomerular filtration rate (GFR) and renal plasma flow (RPF) in 122 patients with lupus nephritis. All patients had definite clinical evidence of active lupus nephritis, including urinary and immunological abnormalities. The average RPF was 634.5 +/- 171.4 ml/min in systemic lupus erythematosus patients and 537.4 +/- 141.9 ml/min in 37 age-and sex-matched patients with primary glomerular disease (PGD) (p < 0.01). A fall in GFR, accompanied by massive proteinuria and hypocomplementemia, was observed frequently in patients with class IV lupus nephritis (diffuse proliferative GN). In contrast, RPF did not change in most patients except in some with increased RPF. No correlation was noticed between RPF and proteinuria or immunological abnormalities. As a result, a marked fall in filtration fraction (FF) was observed frequently in class IV lupus nephritis, and was correlated significantly with urinary and immunological abnormalities. Follow-up data during treatment in the active to inactive phases (average 7.8 months) were available for 39 patients. The average GFR increased significantly from 56.9 +/- 31.4 ml/min in the pre-treatment stage to 74.5 +/- 26.9 ml/min in the post-treatment stage, accompanied by an improvement in proteinuria and hypocomplementemia. On the other hand, RPF decreased significantly from 521.3 +/- 217.1 to 437.6 +/- 156.2 ml/min, so that FF increased significantly as the renal and immunological parameters normalized. Additionally, the renal function was evaluated in 11 patients during the exacerbation of lupus nephritis.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在评估122例狼疮性肾炎患者肾小球滤过率（GFR）和肾血浆流量（RPF）的临床意义。所有患者均有活动性狼疮性肾炎的确切临床证据，包括尿液和免疫学异常。系统性红斑狼疮患者的平均RPF为634.5±171.4 ml/分钟，37例年龄和性别匹配的原发性肾小球疾病（PGD）患者的平均RPF为537.4±141.9 ml/分钟（p<0.01）。IV级狼疮性肾炎（弥漫性增殖性肾小球肾炎）患者经常出现GFR下降，伴有大量蛋白尿和低补体血症。相比之下，除了一些RPF增加的患者外，大多数患者的RPF没有变化。未发现RPF与蛋白尿或免疫学异常之间存在相关性。因此，IV级狼疮性肾炎患者经常出现滤过分数（FF）显著下降，且与尿液和免疫学异常显著相关。39例患者有从活动期到非活动期治疗期间的随访数据（平均7.8个月）。平均GFR从治疗前阶段的56.9±31.4 ml/分钟显著增加到治疗后阶段的74.5±26.9 ml/分钟，同时蛋白尿和低补体血症有所改善。另一方面，RPF从521.3±217.1显著降至437.6±156.2 ml/分钟，因此随着肾脏和免疫学参数恢复正常，FF显著增加。此外，对11例狼疮性肾炎加重期患者的肾功能进行了评估。（摘要截断于250字）
