Buzio C, Allegri L, Mutti A, Perazzoli F, Bergamaschi E
Institute of Clinical Medicine and Nephrology, University of Parma, Italy.
Clin Nephrol. 1994 May;41(5):259-64.
The present study was aimed at assessing the diagnostic value of urinary albumin (uA) excretion rate in the long-term follow-up of patients suffering from acute post-streptococcal glomerulonephritis (APSGN). 26 patients, who had presented primarily with nephritic syndrome and showing increased uA without a concomitant rise in total proteinuria (uTP) were followed-up for 131 months on average (range 36-288). At the last check, 14 patients did not show urinary abnormalities, 9 had a persistent increase in uA, 1 increased uTP and 2 renal insufficiency. Urinary and clinical signs of the disease were not seen during observation periods prolonged for 79 months on average (range 20-156) after normalization of uA. No pathological findings were remarked in biopsy specimens obtained in 3 patients when uA was normalized; in contrast, when both uTP and uA (12 cases) or when isolated uA (14 cases) were increased a pattern of diffuse mesangial proliferative glomerulonephritis was constantly observed. These results indicate that the abnormal uA excretion rate during long-term follow-up of APSGN allows to identify a subset of patients with persistent renal disease; conversely, the occurrence of normal uA seems to point to a good diagnostic and prognostic significance.
本研究旨在评估尿白蛋白（uA）排泄率在急性链球菌感染后肾小球肾炎（APSGN）患者长期随访中的诊断价值。26例主要表现为肾病综合征且uA升高而总蛋白尿（uTP）无相应升高的患者，平均随访131个月（范围36 - 288个月）。在最后一次检查时，14例患者未出现尿液异常，9例uA持续升高，1例uTP升高，2例出现肾功能不全。uA正常化后，平均延长79个月（范围20 - 156个月）的观察期内未出现该疾病的尿液及临床症状。3例uA正常化患者的活检标本未发现病理改变；相反，当uTP和uA均升高（12例）或仅uA升高（14例）时，均持续观察到弥漫性系膜增生性肾小球肾炎的病理模式。这些结果表明，APSGN长期随访期间uA排泄率异常可识别出一部分患有持续性肾病的患者；相反，uA正常似乎具有良好的诊断和预后意义。
