重症兰德里-古兰-巴雷综合征所致急性肾衰竭

Acute renal failure due to severe Landry-Guillain-Barré syndrome.

作者信息

Khajehdehi P, Shariat A, Nikseresht A

机构信息

Department of Internal Medicine, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Iran.

出版信息

Nephrol Dial Transplant. 1998 Sep;13(9):2388-91. doi: 10.1093/ndt/13.9.2388.

DOI:10.1093/ndt/13.9.2388

PMID:9761533

Abstract

BACKGROUND

Blood urea nitrogen (BUN) >60 mg/dl has been reported to occur commonly in patient's with severe Landry-Guillain-Barré syndrome.

AIMS

To find out the cause for this high BUN we compared the renal function tests of 30 consecutive cases with severe Landry-Guillain-Barré syndrome to those of 30 controls.

RESULTS

Acute renal failure occurred in seven patients with Landry-Guillain-Barré syndrome and none of the control group. Acute renal failure was found more in cases with Landry-Guillain-Barré syndrome compared to controls (P=0.0049). Six out of seven cases with Landry-Guillain-Barré syndrome and acute renal failure had dysautonomia and became oliguric while being in a hypotensive state. Of 30 patients with Landry-Guillain-Barré syndrome seven cases died. From eight patients with dysautonomia six cases who had acute renal failure died. The mortality rate was higher in cases with dysautonomia and acute renal failure (P = 0.0001 and 0.00001, respectively). Interestingly no glomerular disease was found.

CONCLUSION

In conclusion acute renal failure can occur commonly in cases with severe Landry-Guillain-Barré syndrome particularly in those with dysautonomia, causing high mortality.

摘要

背景

据报道，重度兰德里-吉兰-巴雷综合征患者中血尿素氮（BUN）>60mg/dl的情况很常见。

目的

为找出BUN升高的原因，我们将30例连续的重度兰德里-吉兰-巴雷综合征患者的肾功能测试结果与30例对照组进行了比较。

结果

7例兰德里-吉兰-巴雷综合征患者发生急性肾衰竭，而对照组无一例发生。与对照组相比，兰德里-吉兰-巴雷综合征患者中急性肾衰竭的发生率更高（P=0.0049）。7例患有兰德里-吉兰-巴雷综合征且发生急性肾衰竭的患者中有6例存在自主神经功能障碍，且在低血压状态下出现少尿。30例兰德里-吉兰-巴雷综合征患者中有7例死亡。8例自主神经功能障碍患者中有6例发生急性肾衰竭并死亡。自主神经功能障碍和急性肾衰竭患者的死亡率更高（分别为P=0.0001和0.00001）。有趣的是，未发现肾小球疾病。