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中華民國泌尿科醫學會雜誌

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篇名 單腎患者之腎功能評估
卷期 2:1
並列篇名 Renal Functional Evaluation in Solitary Kidney Petients
作者 周以和江金培黃俊雄楊朝欽許主培
頁次 382-386
關鍵字 solitary kidneyeffective renal plasma flowglomerular filtration rateTSCI
出刊日期 199103

中文摘要

34名單腎患者平均年齡50.0歲,腎切除經過時間自10天至20年,平均68.2 ± 60.7個月,對照組24人,平均年齡45.6歲,48個腎臟,以99mTc-DPTA檢查個別腎臟之有效腎血漿及腎小球過濾率,並將單腎者及對照組再各依年齡60歲分為年老及年輕者,結果顯示年輕之單腎者的有效腎血漿流量及腎小球過瀘率均較對照組顯著地增加,年老之單腎者的有效血漿流量亦較對照組有顯著地增加,但此種增加在腎小球過濾率並無顯著差別。單腎者的蛋白尿方面,本研究中50%的單腎者有蛋白尿,其中半數合併有糖尿病。至於血清尿素氮,肌氨酸值及血壓方面,單腎者與對照組並無顯著差別。臨床上對於年老人或者潛在性傷害腎臟疾病的患者,施予腎切除應小心從事,不應預期它會有很好的代償性腎臟增殖。(J Urol R.O.C., 2:382-386, 1991)

英文摘要

It has been generally believed that life ex-pectancy is not altered by unilateral nephrecto-my. However, hyperfiltration injury of the rem-nant nephrons have been reported. We identified 34 patients who had under-gone unilateral nephrectomy for unilateral uro-logical problem. The interval from nephrectomy to the present study is 68 months in average 24 persons without renal problem was taken as the contral group. Individual ERPF and GFP were assessed by 99mTC-DTPA gamma - camera renography. Serum BUN, Cr, urine protein, sys-temic blood pressure in the solitary kidney pa-tients were studied as well. The individual ERPF in the solitary kidney patients and control group are 900.4 ± 317.7ml/min and 626.5 ± 215.0ml/min respective-ly. The individual GFR in the solitary kidney patients and control group are 59.6 ± 24.1ml/min and 41.9 ± 12.6ml/min respectively. both GFR and ERPF are statistically significant in the difference between solitary kidney pa-tients and control group. For comparison, the solitary kidney pa-tients were divided into 2 groups. In the young patients, both GFR and ERPF are significantly higher in the solitary kidney patient than the control groups. In the old patientm, the ERPF is significant higher in the solitary kidney patients than the control group. Instead, the difference of GFR between these two groups is not statis-tically significant. About the proteinuria, 50% of the solitary kidney patients had proteinuria, most of them are minor degree, and 50% of those who had proteinuria also suffered from diabetes mellitus. The BUN, Cr and systemic blood pressure showed no significant difference between the solitary kidney patients and control group. We concluded that unilateral nephrectomy is not associated with deterioration in effective renal plasma flow and glomerular filtration rate for up to 20 years. However, the renal function of the solitary kidney patients is better in those under age 60 than those over 60 in compare with control group. Any disease which may po-tentially damage the kidney such as D.M. was an important contributing factor in solitary kid-ney patients with proteinuria.

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