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Renal thrombotic microangiopathies induced by severe hypertension

南京医科大学学报(自然科学版) 2008年第7期 956-956页

作者： Zhang,B. Xing,C.Y. Yu,X.B. Sun,B. Zhao,X.F. Qian,J.Nanjing Med Univ,Affiliated Hosp 1,Dept Nephrol,Nanjing 210029,Peoples R China.

Renal thrombotic microangiopathy(TMA) is an uncommon vascular complication of severe *** now,its clinical-pathological characteristics and renal survival have been ***-one patients with biopsy-proven renal TMA and with severe or malignant hypertension were retrospectively *** the patients exhibited severe hypertension,with systolic blood pressure at 200-280 mmHg and diastolic pressure at 110-180 *** patients had hemorrhagic *** lactate dehydrogenase and thrombocytopenia were found in 6 and 5 patients,*** proteinuria(> 3 g/day) was present in 2 patients and microscopic hematuria in 18 *** patients presented with renal insufficiency(creatinine 3.1 +/-2.1 mg/dL).The level of von Willebrand factor:antigen(vWF:Ag) in patients was not significantly higher than that in the healthy subjects,while the ADAMTS13(a disintegrin and metalloprotease,with thrombospondin-1-like domains) activity was not significantly lower than that in the healthy *** histology showed a TMA involving preglomerular arterioles and/or interlobular arteries character-ized by fibrin deposits and vascular wall *** glomerular microthrombi were not observed in these *** patients required hemodialysis upon admission for severe acute renal *** follow-up,3 patients had recovered normal renal function and 14 had mild renal insufficiency(creatinine 1.8 +/-0.3 mg/dL),while 4 patients still required persistent *** conclusion,compared with patients having hemolytic uremic syndrome/thrombocytopenic purpura,our patients showed a low incidence of throm-bocytopenia and better renal outcome.

关键词： microangiopathy kidney hypertension hemolytic-uremic syndrome von-willebrand-factor systemic-lupus-erythematosus thrombocytopenic purpura disease anemia adults metalloprotease protease

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