成人先天性单肾缺如的临床特征分析  

Clinical characteristics in adults with congenital unilateral renal agenesis

作　　者：汪莺昱[1] 王朝晖[1] 王伟铭[1] 任红[1] 张文[1] 沈平雁[1] 陈楠[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院肾脏科,上海200025

出　　处：《肾脏病与透析肾移植杂志》2010年第2期111-115,163,共6页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：上海市重点学科(T0201);上海市卫生局重点学科基金(05Ⅲ001);上海市科委重点项目(07JC14037);上海市科委重大项目(08dz1900502)

摘　　要：目的:回顾性总结我科成人先天性单肾缺如(URA)患者的临床资料,分析其临床特征。方法:收集我科URA患者49例,记录患者诊断及随访时的临床及实验室数据进行统计分析。结果:成人URA患者的平均诊断年龄为29岁。随访时平均年龄为35.6岁,高血压、蛋白尿和肾功能不全的发病率分别为34.7%、32.7%和30.6%。在诊断原因中占第一位的是体检或其他原因的影像学检查(59.2%)。依据年龄将患者分为青年组和中年组,组间比较发现蛋白尿和高血压的发病率在青年组中均显著低于中年组(P<0.05)。同时依据患者有无高血压和(或)蛋白尿将患者分为有症状组和无症状组,组间比较发现年龄、孤立肾位置、肾脏长径及最大横截面积、SCr、肾小球滤过率和肾功能不全的发病率差异均有显著性(P<0.05)。进一步将患者依据慢性肾脏病分期标准分为5组,发现肾脏长径、最大横截面积及蛋白尿的发病率在组间差异存在显著性(P<0.05)。结论:约三分之一的成人URA患者出现了高血压、蛋白尿及肾功能不全。肾脏长径及最大横截面积、蛋白尿可能与肾功能进展相关。Objective： To analyze the clinical characteristics in adults with congenital unilateral renal agenesis （ URA ） retrospectively. Methodology ： We collected fourty nine patients of URA at Department of Nephrology. Age and first symptom at diagnosis were recorded. Height, weight, age, kidney length, maximal cross section area, blood pressure, urinary albumin-creatinine ratio （ACR）, and serum creatinine （SCr） were examined. Glomerular filtration rate （GFR） was detected by the dual plasma sampling 99mTc-DTPA plasma clearance method. Data were analyzed by SPSS 13.0 software. Results： The mean of age was 29, and 35.6 yrs at diagnosis and follow-up. The incidences of hypertension, proteinuria and renal insufficiency were 34. 7% ,32. 7% and 30. 6%, respectively. The most common reason of consulting was physical examination or radiographic study for other reasons （59. 2% ）. Comparing parameters between youth （ 18 -40 years） and middle age cases （41 -60 years） , the incidences of hypertension and proteinuria were lower significantly in youth patients （P 〈 0. 05）. Meanwhile, based on whether who developed hypertension and/or proteinuria, the cases with and without symptoms group were divided. There were significant differences between two groups in age, solitary kidney location, kidney length and maximal cross section area, SCr, GFR as well as the incidence of renal insufficiency （P 〈 0. 05）. Furthermore, we divided those cases into five groups according to the chronic kidneys disease （CKD） stages in K/DOQI guidelines. There were also statistical differences among five groups in kidney length, maximal cross section area and incidence of proteinuria （ P 〈 0. 05 ）. Conclusion ： Approximately one-third of the adults with URA developed hypertension, proteinuria and renal insufficiency. It was possible that factors of kidney length, maximal cross section area and proteinuria were associaled with progression of renal function.

关 键 词：单肾缺如 临床特征 成人 

分 类 号：R692.1[医药卫生—泌尿科学]