Washio M, Oh Y, Okuda S, Yanase T, Miishima C, Fujimi S, Ohchi N, Nanishi F, Onoyama K, Fujishima M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Clin Nephrol. 1994 May;41(5):265-70.
In order to characterize the clinical features in elderly patients with poststreptococcal glomerulonephritis (PSGN), 31 patients, who were both histologically and immunologically proven to be PSGN, were divided up into 3 groups according to age; elderly patients being 55 years or older (n = 7), middle-aged patients being 40 to 54 years old (n = 7) and younger patients being 20 to 39 years old (n = 17). Renal functional impairment as indicated by serum creatinine levels of over 2.0 mg/dl, developed in 4 of the elderly patients and later completely improved at the end of the follow-up period (178.9 +/- 150.7 days). On the other hand, none of the middle-aged and younger patients revealed any renal function impairment. Hypertension was observed more frequently in elderly patients than in younger patients, and was 86% and 6% at the time of admission, respectively. In addition, 43% of elderly patients remained hypertensive at the time of discharge. There was no difference in total protein, ASO, CH50, the degree of proteinuria or proliferative and exudative features in renal histology among the three groups. None of the elderly patients with PSGN died or developed persistent renal failure. In conclusion, elderly patients with PSGN had a high incidence of renal functional impairment and hypertension compared to the younger patients on admission, however, their short-term prognosis seems to be favorable.
为了描述老年链球菌感染后肾小球肾炎(PSGN)患者的临床特征,31例经组织学和免疫学证实为PSGN的患者根据年龄分为3组;老年患者年龄在55岁及以上(n = 7),中年患者年龄在40至54岁之间(n = 7),年轻患者年龄在20至39岁之间(n = 17)。4例老年患者出现血清肌酐水平超过2.0 mg/dl所提示的肾功能损害,随后在随访期结束时(178.9±150.7天)完全恢复。另一方面,中年和年轻患者均未出现任何肾功能损害。老年患者高血压的发生率高于年轻患者,入院时分别为86%和6%。此外,43%的老年患者出院时仍患有高血压。三组患者在总蛋白、抗链球菌溶血素O(ASO)、补体50(CH50)、蛋白尿程度或肾脏组织学的增殖和渗出特征方面没有差异。PSGN老年患者均未死亡或发生持续性肾衰竭。总之,与年轻患者相比,PSGN老年患者入院时肾功能损害和高血压的发生率较高,然而,他们的短期预后似乎较好。