Korean Journal of Nephrology 1994;13(4):826-831.
질소혈증을 동반한 성인 원발성 신증후군의 임상적 고찰
김난희 , 이영호 , 장미경 , 구자룡 , 차대룡 , 조원용 , 김형규
Abstract
The pathophysiologic mechanisms of azotemia in nephrotic syndrome was supposed to be intravascular volume depletion, renal vein thrombosis, acute inter- stitial nephritis and acute tubular injury due to renal ischemia, but the exact role of those factors was con- troversial. So authors aimed to evaluate the clinical features of azotemia in these patient and to speculate risk fac- tors for development of azotemia. We observe the patient's clinical and laboratory finding, clinical course by retrospective study. 1) The study population consisted of renal dys- function group(6 cases) and normal renal function group(31 cases) in the nephrotic syndrome. The mean age and male to female ratio of each group were 35 years, 6: 0 and 32 years, 23: 8 respe- ctively. 2) The mean serum BUN level was 43.3±20mg/ dl, creatinine 2.36±1.00mg/dl, blood pressure 125/ 82mmHg in the patients group associated with azotemic nephrotic syndrome. 3) The mean serum albumin concentration and urine protein excretion were respectively 2.24±0.83g /dl, 8.67±8.11g/day in the azotemic patients group and these values were not statistically significant dif- ferent from those in normal renal function group. 4) The PRA, aldosterone level were 6.89ng/mL, 326.7ng/dL in some patient with azotemic nephrotic syndrome and 3.68ng/dL, 99.04ng/dL in normal renal function group. 5) Azotemia was documented an average of 12 days after onset of nephrotic syndrome and persisted for 30 days in the six patents in whom recovery of renal function occurred. 6) Of the renal pathologic findings in renal dysfunction group was minimal change disease in 4 cases, then membranoproliferative glomerulonephritis in 1 case and focal segmental glomerulosclerosis in 1 All Azotemia in nephrotic syndrome is recovery in the course. MCNS is the most common finding in patients with azotemic nephrotic syndrome. There is no significant different clinical findings in both two groups, so further investigations are requested to evaluate the risk factor and pathogenesis of azotemia in the nephrotic syndrome.
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