刘美玲, 张炯, 王金泉. 微小病变肾病合并急性肾损伤的研究进展[J]. 临床肾脏病杂志, 2021, 21(10): 855-859. DOI: 10.3969/j.issn.1671-2390.2021.10.010
    引用本文: 刘美玲, 张炯, 王金泉. 微小病变肾病合并急性肾损伤的研究进展[J]. 临床肾脏病杂志, 2021, 21(10): 855-859. DOI: 10.3969/j.issn.1671-2390.2021.10.010
    Liu Mei-ling, Zhang Jiong, Wang Jin-quan. Research advances of minimal change disease combined with acute kidney injury[J]. Journal of Clinical Nephrology, 2021, 21(10): 855-859. DOI: 10.3969/j.issn.1671-2390.2021.10.010
    Citation: Liu Mei-ling, Zhang Jiong, Wang Jin-quan. Research advances of minimal change disease combined with acute kidney injury[J]. Journal of Clinical Nephrology, 2021, 21(10): 855-859. DOI: 10.3969/j.issn.1671-2390.2021.10.010

    微小病变肾病合并急性肾损伤的研究进展

    Research advances of minimal change disease combined with acute kidney injury

    • 摘要: 微小病变肾病(minimal change disease,MCD)是原发性肾病综合征中最常见的病理类型之一,尤其好发于儿童及青少年。肾病综合征患者容易合并一系列并发症,如感染、静脉血栓栓塞、急性肾损伤(acute kidney injury,AKI)等。近年来肾病综合征合并AKI的发病率明显上升,其中以MCD合并AKI最为常见。MCD合并AKI会致使患者病情加重,增加临床治疗难度,并与肾脏不良预后密切相关。MCD合并发生AKI的机制涉及多种不同途径,常见的包括有效循环血容量下降导致的肾小球滤过率下降,肾血管病变带来的肾单位缺血,以及蛋白尿对肾小管的直接毒性作用,等等。本文回顾近年来有关MCD合并AKI领域的临床和基础研究,对其发病率、病理生理学机制、早期的诊断指标和防治原则进行综述,旨在提高临床对MCD合并AKI的认识和诊疗水平。

       

      Abstract: Minimal change disease(MCD) is one of the most common types of pathology for primary nephrotic syndrome, especially in children and adolescents. Patients with nephrotic syndrome are prone to a series of complications, such as infection, venous thromboembolism and acute kidney injury(AKI), etc. In recent years, the incidence of nephrotic syndrome complicated with AKI has spiked markedly. And MCD complicated with AKI is the most common. MCD with AKI shall aggravate patient conditions, compound the difficulty of clinical treatment and bring a worse clinical prognosis. The mechanism of MCD associated with AKI involves a variety of different pathways, including a reduction of glomerular filtration rate(GFR) due to a lower effective circulating blood volume, nephronic ischemia resulting from renal vascular lesions and a direct toxic effect of proteinuria on renal tubules, etc. This review summarized clinical and basic researches in the field of MCD combined with AKI in recent years. It also described its incidence, pathophysiological mechanism, early diagnostic indicators and prevention and treatment principles for a better management of MCD combined with AKI.

       

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