原发性肾病综合征并发急性肾功能衰竭的临床与病理分析

目的；观察原发性肾病综合征(iNS)并发急性肾功能衰竭(ARF)的临床与病理。方法：对42例iNS并发ARF患者临床和病理改变进行分析。结果：iNS并发ARF的发生率为5．87％，临床上以少尿型为主(78．6％)．起病均在iNS的急性期。42例患者临床表现为大量蛋白尿、高度水肿，病程中无明显诱因出现少尿，尿素氮与血清肌酐增高。肾脏病理检查肾小球以轻微改变为主，其中微小病变型16例．轻度系膜增生型肾炎2l例；肾小管间质的病变却表现为广泛肾间质水肿及小管上皮细胞灶性坏死。经利尿、强的松等治疗后，36例患者肾功能逐渐恢复正常。结论：iINS并发ARF多发生于肾小球轻微改变者；尽早明确iNS并发ARF，并给予适当治疗，绝大多数患者肾功能可以恢复。

Clinical and pathological analysis of ARF in idiopathic nephrotic syndrome

Objectives: To study the clinical and pathology of patients w ith idiopathic nephrotic syndrome(iN S) complicated with acute renal fail ure(ARF) Methods: The data of cl inical and pathological of 42 patients w ith iNS complicated with ARF were co llected and analysed Results: WT 6BZ]The incidence rate of ARF in iNS was 5 87% The patients manifested oliguria type(78 6%),most ARF happened behind acute stage of iNS in three months, the main clinical manifestations in these cases were heavy proteinuria a nd severe edema Sudden oliguria,incr ease of blood urea nitrogen and crea tinine occurred without any definite cause Pathological examination show ed near normal glomeruli,as well as, minimal change disease(16 cases),mil d mesangial proliferative glomerulon ephritis(21 cases),diffuse interstit ial edema and patchy necrosis of the tubular cells The renal function in most of patients recovered after tr eating with diuretics,prednisone,etc Conclusions: It is shown t hat AR F in iNS commonly occurred in patients w ith near normal glomeruli Early trea tment is necessary if diagnosing iNS complicated ARF,the ARF was mostly reversible