腎皮質壞死
腎皮質壞死 (Renal cortical necrosis) | |
---|---|
类型 | 腎病變、肾皮质病变[*] |
分类和外部资源 | |
醫學專科 | 泌尿外科 |
ICD-10 | N17.1 |
ICD-9-CM | 583.6 |
eMedicine | article/983599 於 eMedicine |
腎皮質壞死(Renal cortical necrosis、RCN,瀰漫性雙側腎皮質壞死(diffuse bilateral renal cortical necrosis、BRCN)、,瀰漫性皮質壞死(diffuse cortical necrosis)、急性皮質壞死(acute cortical necrosis)、急性皮質壞死急性腎功能衰竭(acute renal failure with acute cortical necrosis))是急性腎功能衰竭的一種罕見病症。該病症"通常通過顯著減少腎動脈灌注(Perfusion)繼發於血管痙攣、微血管損傷,或彌散性血管內凝血",以及由急性腎小管壞死的病理進展所致。[1]經常伴隨著產科病症發生、諸如胎盤早剝(Placental abruption)及敗血性休克,而且是三倍多見於發展中國家與工業化國家中(佔急性腎損傷的病因2%-6%)。
病因
成年人
- 妊娠相關(病例>50%)。
- HIV[2]
- 蛇咬傷[3]
- 暴飲[4]
- 休克
- 創傷
- 鐮刀型紅血球疾病[5]
- 紅斑性狼瘡(SLE)[6]
- 敗血症[7]
- SLE相關抗磷脂综合征[8]
- 維生素缺乏症[9]
- 胰腺炎[10]
- 疟疾[11]
- 腦膜炎球菌病(Meningococcemia)[12]
- 藥物引起的中毒(比如NSAIDs、造影劑(Contrast Media)、奎寧、[13]或ATRA[14])
新生兒
- 先天性心臟缺損(Congenital heart disease)
病理生理學
診斷
治療
患者需要以透析來彌補其腎臟的功能。
預後
皮質壞死是一種嚴重的危及生命的病症,且死亡率超過50%。
註釋
- ^ Deverajan, Prasad. Langman, Craig B , 编. eMedicine: Renal Cortical Necrosis. Medscape. May 26, 2011 [27 March 2012]. (原始内容存档于2021-08-29).
- ^ Bakshsish Singh, Ankur Gupta, Sandeep Mahajan, Ruchika Gupta. Acute cortical necrosis and collapsing glomerulopathy in an HIV-infected patient: a rare clinical scenario. Saudi Journal of Kidney Diseases and Transplantation: An Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia. 2012-03, 23 (2): 363–366 [2019-02-12]. ISSN 1319-2442. PMID 22382240. (原始内容存档于2019-08-23).
- ^ Susheel Kumar, Aman Sharma, Kushaljit S. Sodhi, Ajay Wanchu, Niranjan Khandelwal, Surjit Singh. Renal cortical necrosis, peripheral gangrene, perinephric and retroperitoneal haematoma in a patient with a viper bite. Tropical Doctor. 2012-04, 42 (2): 116–117 [2019-02-12]. ISSN 1758-1133. PMID 22316624. doi:10.1258/td.2011.110281. (原始内容存档于2019-08-23).
- ^ Yeon Soon Jung, Ho Sik Shin, Hark Rim, Kiseok Jang, Moon Hyang Park, Joon-Sung Park, Chang-Hwa Lee, Gheun-Ho Kim, Chong Myung Kang. Bilateral renal cortical necrosis following binge drinking. Alcohol and Alcoholism (Oxford, Oxfordshire). 2012-03, 47 (2): 140–142 [2019-02-12]. ISSN 1464-3502. PMID 22215004. doi:10.1093/alcalc/agr154. (原始内容存档于2019-08-22).
- ^ S. Shiradhonkar, R. Jha, B. S. Rao, G. Narayan, S. Sinha, G. Swarnalata. Acute cortical necrosis following renal transplantation in a case of sickle cell trait. Indian Journal of Nephrology. 2011-10, 21 (4): 286–288 [2019-02-12]. ISSN 1998-3662. PMC 3193676 . PMID 22022093. doi:10.4103/0971-4065.78066. (原始内容存档于2019-08-13).
- ^ Megha S. Uppin, Liza Rajasekhar, H. Swetha, V. R. Srinivasan, Aruna K. Prayaga. Renal cortical necrosis at presentation in a patient with systemic lupus erythematosus: an autopsy case report. Clinical Rheumatology. 2010-07, 29 (7): 815–818 [2019-02-12]. ISSN 1434-9949. PMID 20169460. doi:10.1007/s10067-010-1395-5. (原始内容存档于2019-08-21).
- ^ Chun-Chao Huang, Jon-Kway Huang. Sepsis-induced acute bilateral renal cortical necrosis. Nephrology (Carlton, Vic.). 2011-11, 16 (8): 787 [2019-02-12]. ISSN 1440-1797. PMID 22029648. doi:10.1111/j.1440-1797.2011.01478.x. (原始内容存档于2019-08-21).
- ^ Jin Ok Kim, Gheun-Ho Kim, Chong Myung Kang, Joon-Sung Park. Bilateral acute renal cortical necrosis in SLE-associated antiphospholipid syndrome. American Journal of Kidney Diseases: The Official Journal of the National Kidney Foundation. 2011-06, 57 (6): 945–947 [2019-02-12]. ISSN 1523-6838. PMID 21514023. doi:10.1053/j.ajkd.2011.02.381. (原始内容存档于2019-08-26).
- ^ Cristina Novembrino, Rachele De Giuseppe, Federica de Liso, Paola Bonara, Fabrizia Bamonti. Vitamin deficiency and renal cortical necrosis. Lancet (London, England). 2010-07-17, 376 (9736): 160; author reply 161 [2019-02-12]. ISSN 1474-547X. PMID 20638557. doi:10.1016/S0140-6736(10)61101-4. (原始内容存档于2019-08-23).
- ^ G. S. R. Krishna, K. C. Kishore, N. P. Sriram, V. V. Sainaresh, A. Y. Lakshmi, V. Siva Kumar. Bilateral renal cortical necrosis in acute pancreatitis. Indian Journal of Nephrology. 2009-07, 19 (3): 125 [2019-02-12]. ISSN 1998-3662. PMC 2859480 . PMID 20436735. doi:10.4103/0971-4065.57112. (原始内容存档于2019-08-22).
- ^ K. V. Baliga, A. S. Narula, R. Khanduja, M. Manrai, P. Sharma, N. S. Mani. Acute cortical necrosis in Falciparum malaria: an unusual manifestation. Renal Failure. 2008, 30 (4): 461–463 [2019-02-12]. ISSN 1525-6049. PMID 18569922. doi:10.1080/08860220801964293. (原始内容存档于2019-08-18).
- ^ H.-S. Toh, K.-C. Cheng, W.-K. Kuar, C.-K. Tan. The Case. Generalized petechiae and acute renal failure: bilateral renal cortical necrosis in meningococcemia. Kidney International. 2008-06, 73 (12): 1443–1444 [2019-02-12]. ISSN 1523-1755. PMID 18516063. doi:10.1038/ki.2008.143. (原始内容存档于2019-08-19).
- ^ F. Leroy, F. Bridoux, R. Abou-Ayache, S. Belmouaz, E. Desport, A. Thierry, M. Bauwens, G. Touchard. [Quinine-induced renal bilateral cortical necrosis]. Nephrologie & Therapeutique. 2008-06, 4 (3): 181–186 [2019-02-12]. ISSN 1769-7255. PMID 18343736. doi:10.1016/j.nephro.2008.01.001. (原始内容存档于2019-08-20).
- ^ A. Sastre López, E. Gago González, M. Baños Gallardo, E. Gómez-Huertas, F. Ortega Suárez. [All-trans retinoic acid syndrome [corrected] and renal cortical necrosis]. Anales De Medicina Interna (Madrid, Spain: 1984). 2007-11, 24 (11): 551–553 [2019-02-12]. ISSN 0212-7199. PMID 18275266.