Korean Journal of Nephrology 1993;12(4):542-548.

성인의 미세변화 신증후군에 대한 임상적 고찰

김영수 , 이준상 , 김성일 , 김무영 , 양용석 , 황병욱 , 곽임수 , 나하연

Abstract

A series of 51 adult-onset nephrotic syndrome with minimal change on renal biopsy admitted to Pusan National University Hospital between 1985 to 1991 was analyzed to examine the characteristics, laboratory findings and respose to steroid therapy. 1) The number of minimal change nephrotic syndrome was 51 cases of 221 adultonset nephrotic syndrome on biopsy, and the male to female ratio was 2.2: 1 with male predominance. 2) In most patients, the serum albumin was below 2.5 g/dl (97%) and mean serum albumin level was 2.0 g/ dl. In daily urine protein excretion, 78% of the patients ranged from 4 to 15 g/day and mean daily urine protein excretion was 11. 4 g/day. 3) 53% of Minimal change nephrotic syndrome patients showed from 251 to 400 mg/dl in serum cho- lesterol level and 86% of patients above 251 mg/dl, 33% above 400 mg/dl. In most patients, RBC number in urinary sediment was below 10 at HPF microscopic examination and one patient had macroscopic hematuria. 4) Hypertension was present in 8 of 51 patients and 3 patients had severe hypertension (diastolic BP>110 mmHg). Renal impairment was present 9 of 51 patients. 5) The response of adult-onset minimal change ne- phrotic ysndrome to steroid therapy showed complete remission in 82%, partial remission in 10%., and no response in 8% and 60% of the patients went into remission in 82%, partial remission in 10%, and no response in 8% and 60%of the patients went into remission within 4 weeks of starting steroid therapy, 78% within 8 weeks. 6) The 16 patients of 41 patients went to remission relapsed, of them 12 patients showed single recrrence and 4 patients showed multiple recurrence. In conclusion, some difference of the results of western population, our results indicate that the rate of minimal change nephrotic syndrome of adult-onset nephrotic syndrome on biopsy was higher and the male preponderated over the female, the reccurence rate was lower than the other reports.