The Nephrotic Syndrome in Adults Aged over Forty

中老年人之腎病徵候群

馮祥華(Shyang-Hwa Ferng) ； 謝善德(Shang-Der Shieh) ； 范成得(Cherng-Der Fan) ； 朱伯齡(Pau-Ling Chu)

《Journal of Medical Sciences》 9卷6期 (1989/12) Pp. 383-391

摘要

The nephritic syndrome occurring in patients over the age of 40 is not so rare and may be secondary to another disease or malignancy. These patients are not studied routinely as a special group. We present data on 45 patients aged over 40 with diagnosis of nephritic syndrome and compare them with young adults below 40-year old who had nephritic syndrome. The patient over 40-year old had hypertension and/or diminished renal function more often (p＜0.005) than patients less than 40. Their biochemical findings presented with significantly (p＜0.01) higher serum albumin, IgG, and lower cholesterol level than those young patients. There was no significant difference in serum creatinine, BUN and daily urine protein loss between two groups. Percutaneous needle renal biopsy was performed in 24 cases in the group and 30 cases in young adults group. The major change of pathological finding was membranous nephropathy in old adults (13 cases), minimal change disease in young adults (20 cases). The elder patients, four of them with membranous nephropathy had malignancy of lung, stomach or colon, were slow and less response to both corticosteroids and cyclophosphamide therapy (p＜0.05). Because of difference in some clinical presentation, particular etiology and therapeutic response from the condition occurring in young adults, these nephritic patients whose age over 40 should be considered as a special group with particular disease entity.

關鍵字

腎病徵候群 ； 膜厚性腎病

並列摘要

The nephritic syndrome occurring in patients over the age of 40 is not so rare and may be secondary to another disease or malignancy. These patients are not studied routinely as a special group. We present data on 45 patients aged over 40 with diagnosis of nephritic syndrome and compare them with young adults below 40-year old who had nephritic syndrome. The patient over 40-year old had hypertension and/or diminished renal function more often (p＜0.005) than patients less than 40. Their biochemical findings presented with significantly (p＜0.01) higher serum albumin, IgG, and lower cholesterol level than those young patients. There was no significant difference in serum creatinine, BUN and daily urine protein loss between two groups. Percutaneous needle renal biopsy was performed in 24 cases in the group and 30 cases in young adults group. The major change of pathological finding was membranous nephropathy in old adults (13 cases), minimal change disease in young adults (20 cases). The elder patients, four of them with membranous nephropathy had malignancy of lung, stomach or colon, were slow and less response to both corticosteroids and cyclophosphamide therapy (p＜0.05). Because of difference in some clinical presentation, particular etiology and therapeutic response from the condition occurring in young adults, these nephritic patients whose age over 40 should be considered as a special group with particular disease entity.

並列關鍵字

Nephrotic syndrome ； Membranous nephropathy