Incidence of microalbuminuria in children with pyelonephritic scarring
Incidence of microalbuminuria in children with pyelonephritic scarring
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DOI：
10.1007/s004670050194
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发表时间：
1996-12-01
影响因子：
3
通讯作者：
Aperia, A
中科院分区：
文献类型：
--
作者：
Karlen, J;Linne, T;Aperia, A
有实验证据表明，肾实质的丧失导致残余肾小球的过度滤过，随后发生肾小球硬化。微量白蛋白尿，即尿白蛋白排泄率为20-200μg/min，被认为是糖尿病肾小球硬化症的早期预测因子。假设，肾盂肾炎疤痕患者尿白蛋白排泄增加也可能表明肾小球硬化，并有未来肾功能恶化的风险。本研究的目的是确定患有轻度至中度肾盂肾炎疤痕的儿童中白蛋白排泄增加的发生率，并将这些信息与肾小球滤过率（GFR；菊粉清除率）和有效肾血浆流量（对氨基马尿酸的清除率）以及疤痕程度相关联。功能研究是在水利尿情况下进行的。该研究纳入了 57 名患有肾盂肾炎肾疤痕的儿童，年龄为 1.7-17.9 岁。九名年轻健康成年人被用作对照。肾盂肾炎疤痕儿童的 GFR 显着低于对照组（中位 93 ml/min 每 1.73 m(2)，范围 48-133 vs. 111 ml/min 每 1.73 mt，范围 89-121，P < 0.05），并且尿白蛋白排泄量显着较高（中位 20 μg/min 每 100 mi GFR，范围51% 的患有肾盂肾炎疤痕的儿童中发现，每 100 mi GFR 为 0.8-170 与 9.2 μg/min（范围为 3.3-21，P20 μg/min/100 mi GFR），而只有 14% 的儿童的年龄调整血清肌酐浓度有所增加。肾盂肾炎疤痕儿童微量白蛋白尿的高发生率表明需要长期随访，直到更好地确定最终结果。
There is experimental evidence that loss of renal parenchyma results in hyperfiltration in the remnant glomeruli followed by development of glomerulosclerosis. Microalbuminuria, i.e., a urinary albumin excretion rate of 20-200 mu g/min, is considered to be an early predictor of diabetic glomerulosclerosis. Hypothetically, increased urinary albumin excretion in patients with pyelonephritic scarring may also indicate glomerulosclerosis, with risk for future deterioration of renal function. This study was performed to determine the incidence of increased albumin excretion in children with mild to moderate pyelonephritic scarring, and to relate the information to glomerular filtration rate (GFR; clearance of inulin) and effective renal plasma flow (clearance of para-aminohippuric acid), as well as to the degree of scarring. The functional investigations were performed under water diuresis. Fifty-seven children, aged 1.7-17.9 years, with pyelonephritic renal scarring were included in the study. Nine young healthy adults were used as controls. The GFR was significantly lower in the children with pyelonephritic scarring than in the controls (median 93 ml/min per 1.73 m(2), range 48-133 vs. 111 ml/min per 1.73 mt, range 89-121, P < 0.05), and the urine albumin excretion was significantly higher (median 20 mu g/min per 100 mi GFR, range 0.8-170 vs. 9.2 mu g/min per 100 mi GFR, range 3.3-21, P20 mu g/min per 100 mi GFR) was found in 51% of the children with pyelonephritic scarring, while only 14% had increased age-adjusted serum creatinine concentrations. The high incidence of microalbuminuria in children with pyelonephritic scarring indicates long-term follow-up until the ultimate outcome has been better defined.