【膜性肾病——在Rzeszow的St. Queen Jadwiga临床区医院第二内科、肾脏病学和内分泌科接受肾活检的患者中最常见的肾小球病变】。

Przeglad lekarski Pub Date : 2017-01-01
Aneta Kołodziej-Kłęk, Agnieszka Gala-Błądzińska, Krzysztof Okoń, Agnieszka Sadowska, Grzegorz Świder
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摘要

我们回顾性分析了主要在St.Queen Jadwiga临床区医院内科、肾脏病学和内分泌科住院的52例女性、62例男性和6例儿童进行的120例肾活检的结果。2 .从2013年到2016年在Rzeszów。肾活检患者的平均年龄为44岁(7-78岁)。肾活检最常见的适应症为肾病综合征47例(37.3%),非肾病性蛋白尿31例(24.6%),肾功能恶化22例(17.5%),蛋白尿合并血尿16例(12.7%),肾病综合征9例(7.1%),单纯性血尿1例(0.8%)。膜性肾小球肾炎是活检中最常见的组织学诊断,确诊19例(15.1%)。14例患者被诊断为狼疮性肾炎(11.1%)。我们诊断局灶性肾小球硬化和系血管增殖性肾小球肾炎的频率相同(11例,8.7%)。10例(7.9%)诊断为膜增生性肾小球肾炎。其他肾病占所有诊断的不到8%。大多数膜性肾病患者(8例,61%)存在针对磷脂酶A2受体的抗体。所有诊断为膜性肾病的患者均接受肾素-血管紧张素-醛固酮系统阻断治疗,13例患者(68.4%)接受免疫抑制治疗。11例(64.7%)原发性膜性肾病患者获得完全缓解。在所有接受肾活检的患者中,有35例(27.8%)患者在手术后出现临床不明显的小肾周血肿并发症。血尿7例(5.56%)。在一个病例中,由于腹膜后出血,患者需要输血。
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[Membranous nephropathy - the most commonly diagnosed glomerulopathy in patients who underwent renal biopsy in the Department of Internal Medicine, Nephrology and Endocrinology St. Queen Jadwiga Clinical District Hospital No. 2 in Rzeszow].

We retrospectively analysed the results of 120 renal biopsy, performed in 52 women, 62 men and 6 children hospitalized mainly in the Department of Internal Medicine, Nephrology and Endocrinology St. Queen Jadwiga Clinical District Hospital No. 2 in Rzeszów from 2013 to 2016. The average age of patients on whom renal biopsy was performed amounts to 44 (7-78) years. The most common indications for renal biopsy were nephrotic syndrome in 47 patients (37.3%), non-nephrotic proteinuria in 31 patients (24.6%), worsening renal function in 22 patients (17.5%), coexistence proteinuria with hematuria in 16 patients (12.7%), nephritic syndrome in 9 patients (7.1%) as well as an isolated hematuria in 1 patient (0.8%). Membranous glomerulonephritis was the most common histological diagnosis observed in biopsies, and was diagnosed in 19 patients (15.1%). In 14 patients we diagnosed lupus nephritis (11.1%). With the same frequency we diagnosed focal glomerulosclerosis, and mesangioproliferative glomerulonephritis (11 patients, 8,7%). Membraneproliferative glomerulonephritis was diagnosed in 10 patients (7.9%). Other nephropathy accounted for less than 8% of all diagnoses. Most patients with membranous nephropathy (8 patients, 61%) had antibodies against phospholipase A2 receptor. All patients with a diagnosis of membranous nephropathy received the renin- angiotensin-aldosterone system blockade, and 13 patients (68.4%) received immunosuppressive therapy. Complete remission was achieved in 11 patients (64.7%) with primary membranous nephropathy. In 35 patients (27.8%) of all patients who underwent renal biopsy they had complications after procedure in the form of small and clinically insignificant perirenal hematomas. Hematuria was observed in 7 cases (5.56%). In one case, due to retroperitoneal bleeding, the patient required a transfusion of blood products.

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