45 YEAR FOLLOW-UP AFTER UNINEPHRECTOMY
45 YEAR FOLLOW-UP AFTER UNINEPHRECTOMY
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DOI：
10.1038/ki.1993.156
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发表时间：
1993-05-01
影响因子：
19.6
通讯作者：
MEYER, TW
中科院分区：
文献类型：
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作者：
NARKUNBURGESS, DM;NOLAN, CR;MEYER, TW
本研究调查了在第二次世界大战期间因创伤而失去肾脏的美国陆军人员进行肾脏切除术的后果。对平均年龄为25岁的62名军人进行了肾切除术。与同年龄的二战军人的死亡率进行了比较。回顾了28例死亡受试者的医疗记录，以寻找肾脏疾病的证据。收集28名在世受试者的病史，并对其血压和肾功能进行评估。两名受试者无法定位，四名受试者拒绝参与。肾切除术患者45岁时的死亡率没有增加。28例死亡受试者中有6例存在肾脏疾病，可归因于先前肾切除术以外的原因。在10名进行尸检的受试者中，肾小球硬化没有增加。在活着的受试者中，高血压的患病率没有增加。28例活着的受试者中有5例肾功能异常，表现为蛋白尿超过250 mg/d的4例（范围：377 ~ 535 mg/d），血清肌酐水平超过1.5 mg/dl的3例（范围：1.7 ~ 1.9 mg/dl）。除肾切除术外的其他情况也可能导致这些受试者的肾功能受损。这些发现表明，在45岁以上的年轻人中，非肾切除术几乎没有重大的不良后果。
This study examined the consequences of nephrectomy in United States Army personnel who lost a kidney due to trauma during World War II (WWII). Records of 62 servicemen who underwent nephrectomy at an average age of 25 years were obtained. Mortality was compared with that of WWII servicemen of the same age. Medical records of 28 deceased subjects were reviewed for evidence of kidney disease. Medical histories were obtained and blood pressure and kidney function were assessed in 28 living subjects. Two subjects could not be located, and four subjects declined to participate. Mortality at 45 years was not increased in nephrectomized subjects. Kidney disease present in six of 28 deceased subjects was attributable to causes other than prior nephrectomy. Glomerular sclerosis was not increased in 10 subjects who had autopsy examinations. The prevalence of hypertension was not increased in living subjects. Five of 28 living subjects had abnormal renal function manifested by proteinuria greater than 250 mg/day in four cases (range: 377 to 535 mg/day) and serum creatinine levels greater than 1.5 mg/dl in three cases (range: 1.7 to 1.9 mg/dl). Conditions other than nephrectomy could have contributed to impairment of renal function in each of these subjects. These findings suggest that uninephrectomy in young adults has few major adverse consequences over 45 years.