老年肾病综合征并发急性肾功能衰竭21例临床分析

目的　深入探讨老年肾病综合征 (NS)并发急性肾功能衰竭 (ARF)的临床、病理及预后。　 方法　对 2 1例老年及 3 8例非老年NS并发ARF患者的病因、临床特征、病理特点以及预后等进行回顾性分析。　 结果　老年组NS并发ARF发病率为 2 4 7% ;非老年组为 7 3 %。老年组与非老年组比较有以下特点 :(1)老年NS并发ARF发病率高 ,男性多见 (71 4% ) ,病死率高 ,治愈率低 ;(2 )蛋白尿程度极重、血浆蛋白极低 ;(3 )病理以膜性肾病、局灶节段性肾小球硬化多见 ;(4 )病因以原发性肾小球疾病、糖尿病肾病为主。　 结论 　老年NS并发ARF发病率高 ,病理以膜性肾病、局灶节段性肾小球硬化为主 ,蛋白尿及低蛋白血症严重 ,预后差。

Clinical analysis of 21 cases of acute renal failure in elderly nephrotic syndrome

Objective To explore the clinical feature,pathology and prognosis in elderly nephrotic syndrome(NS) with acute renal failure(ARF). Methods Twenty-one elderly and 38 young cases of NS with ARF were analysed retrospectively. Results The incidence of NS complicated with ARF was 7.3% in the young and 24.7% in the elderly patients.The elderly patients had some characteristics as compared with young patients:1.The incidence of NS complicated with ARF was high.71.4% of patients were male.Clinical mortality was high and cure rate was low;2.Proteinuria was severe and plasma albumin was very low;3.Membranous nephropathy,focal and segmental glomerusclerosis were common;4.Etiology was found to be idiopatic glomerulonephritis and diabetic nephropathy. Conclusions The incidence of NS complicated with ARF is high and it often has poor prognosis.Proteinuria and hypoproteinemia were severe.Membranous nephropathy,focal and segmental glomerusclerosis are the common type in biopsy.