Kidney Function and Histological Damage in Autopsy Subjects with Myocardial Infarction
Kidney Function and Histological Damage in Autopsy Subjects with Myocardial Infarction
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DOI：
10.3109/0886022x.2011.605531
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发表时间：
2011-01-01
期刊：
影响因子：
3
通讯作者：
Kawano, Yuhei
中科院分区：
文献类型：
--
作者：
Niizuma, Shinichiro;Nakamura, Satoko;Kawano, Yuhei
目的：慢性肾脏病（CKD）是心血管疾病（CVD）的主要危险因素。我们之前报道过尸检对象中风或腹主动脉瘤的肾实质损伤。本研究的目的是评估心肌梗死（MI）患者肾脏组织学与临床特征之间的关系。方法：在国立脑心血管中心医院对699例受试者进行尸检。我们回顾性评估了所有患有 MI 的尸检病例 (n = 123)。使用日本公式计算估计肾小球滤过率（eGFR）。将受试者分为四组：25 名 eGFR >= 60 mL/min/1.73 m(2) 且无蛋白尿（无 CKD）的受试者、10 名 eGFR >= 60 且有蛋白尿的受试者 (CKD1/2)、65 名 eGFR >= 30 的受试者 (CKD3) 和 23 名 eGFR < 30 的受试者 (CKD4/5)。使用半定量组织学评分（评分 0-3）评估肾实质损伤，包括肾小球硬化、间质纤维化、肾小管萎缩、小动脉透明变性和中等动脉硬化（最高评分 = 15）。结果：CKD3 和 CKD4/5 患者的平均组织学评分显着较高，且与年龄、高血压、糖尿病、肾功能、蛋白尿和其他 CVD 相关。结论：在 MI 患者中，肾实质损伤与肾功能恶化密切相关。
Objectives: Chronic kidney disease (CKD) is a major risk factor for cardiovascular disease (CVD). We previously reported renal parenchymal damage in autopsy subjects with stroke or abdominal aortic aneurysm. The aim of this study is to evaluate the relationship between renal histology and clinical characteristics of patients with myocardial infarction (MI). Methods: A total of 699 subjects were autopsied at the National Cerebral and Cardiovascular Center Hospital. We retrospectively evaluated all autopsy cases with MI (n = 123). Estimated glomerular filtration rate (eGFR) was calculated using the Japanese formula. Subjects were classified into four groups: 25 subjects with eGFR >= 60 mL/min/1.73 m(2) and no proteinuria (no CKD), 10 subjects with eGFR >= 60 and proteinuria (CKD1/2), 65 subjects with 60 > eGFR >= 30 (CKD3), and 23 subjects with eGFR < 30 (CKD4/5). Renal parenchymal damage was evaluated using a semi-quantitative histological score (score 0-3) for glomerulosclerosis, interstitial fibrosis, tubular atrophy, arteriolar hyalinosis, and arteriosclerosis of medium-sized artery (maximum score = 15). Results: The mean histological score was significantly higher in patients with CKD3 and CKD4/5 and was associated with age, hypertension, diabetes, kidney function, proteinuria, and other CVD. Conclusions: In patients with MI, renal parenchymal damage and deteriorating kidney function are closely associated.