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目的探讨小儿原发性肾病综合征(PNS)并发急性肾功能衰竭(ARF)的临床特点。方法对本院2001年1月～2009年8月收治的578例PNS患儿的临床资料特点进行回顾性分析。结果 578例PNS患儿中8例并发ARF,其发生率为1.38%;8例中7例合并感染。8例患儿确诊后,治疗上主要使用肾上腺皮质激素,2例患儿联合环磷酰胺静脉冲击治疗,2例患儿接受血液透析治疗。经积极治疗后4例患儿肾功能恢复正常,2例肾功能好转,3例单纯型肾病中2例肾功能于2周内恢复。结论感染可能为PNS患儿并发ARF的诱因;单纯型肾病并发ARF经积极综合治疗预后较肾炎性肾病好;积极控制肾病状态有利于ARF的恢复。
Objective To investigate the clinical features of children with primary nephrotic syndrome (PNS) complicated with acute renal failure (ARF). Methods The clinical data of 578 PNS patients admitted to our hospital from January 2001 to August 2009 were retrospectively analyzed. Results Among 578 PNS children, 8 cases were complicated with ARF, the incidence rate was 1.38%; 7 of 8 cases were complicated with infection. Eight patients were diagnosed with adrenal cortical hormone. Two patients received intravenous cyclophosphamide and two received hemodialysis. After active treatment, the renal function returned to normal in 4 cases, renal function improved in 2 cases, and renal function recovered in 2 cases in 3 cases of simple nephropathy. Conclusions Infection may be the cause of ARF in children with PNS. The prognosis of simple nephrotic syndrome complicated with ARF is better than that of nephritic nephropathy. Active control of nephropathy is beneficial to the recovery of ARF.