Raij L, Keane W F, Leonard A, Shapiro F L
Am J Med. 1976 Aug;61(2):207-14. doi: 10.1016/0002-9343(76)90171-6.
In five adult patients (aged 44 to 74 years) with idiopathic nephrotic syndrome, irreversible acute renal failure developed. Prior renal disease, associated systemic illness or occlusion of major renal vasculature was not present. All patients continued to excrete large amounts of proteins (8.6 to 15 g/24 hours) despite a minimal glomerular filtration rate and severe oliguria. One patient died after five months without recovering renal function. Four patients have required hemodialysis for a period of 12 to 58 months. The failure to recover renal function could not be explained by the light microscopic findings. It is suggested that the irreversibility of the renal failure may be related to either permanent alterations in renal blood flow or ultrastructural changes, or to both. Clinically, adult patients in whom acute renal failure develops during the course of idiopathic nephrotic syndrome seem to have a grave prognosis. Protracted oliguria or irreversible renal failure can be expected to occur.
在5例患有特发性肾病综合征的成年患者（年龄44至74岁）中，出现了不可逆的急性肾衰竭。患者既往无肾脏疾病、相关全身性疾病或主要肾血管闭塞。尽管肾小球滤过率极低且严重少尿，但所有患者仍持续大量蛋白尿（8.6至15克/24小时）。1例患者在5个月后死亡，肾功能未恢复。4例患者需要进行12至58个月的血液透析。肾功能未能恢复无法通过光镜检查结果解释。提示肾衰竭的不可逆性可能与肾血流的永久性改变或超微结构变化有关，或两者皆有关。临床上，在特发性肾病综合征病程中发生急性肾衰竭的成年患者预后似乎很差。预计会出现持续性少尿或不可逆的肾衰竭。
