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Nephrogenic systemic fibrosis: a report of 29 cases.

机译:肾源性系统性纤维化:29例报告。

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OBJECTIVE: The purpose of this study was to determine the incidence of nephrogenic systemic fibrosis and its relation to renal failure and the administration of gadolinium-based contrast material at an academic medical center. MATERIALS AND METHODS: A dermatopathology database was searched to identify patients in whom nephrogenic systemic fibrosis was diagnosed. The medical records of these patients were reviewed. Renal function concurrent with any administration of gadolinium-based contrast material was assessed, as was patient outcome. A database of patients undergoing long-term dialysis was reviewed separately to determine how many had received gadolinium and the frequency of nephrogenic systemic fibrosis among these patients. RESULTS: Twenty-nine patients were found to have had nephrogenic systemic fibrosis between November 15, 1999, and December 31, 2006. It was known that gadolinium-based contrast material had been administered to 25 of these patients before diagnosis. All 29 patients had compromised renal function (27 had chronic renal failure, and two had acute renal failure). Determination of the temporal relation between gadolinium-based contrast administration and symptom onset often was difficult. Only eight patients had severe morbidity. Nephrogenic systemic fibrosis developed in 12 (2.9%) of 414 patients undergoing long-term dialysis who received gadolinium-based contrast material. CONCLUSION: We confirm the strong association between nephrogenic systemic fibrosis and gadolinium-based contrast administration. Although the use of high doses of gadolinium and the occurrence of chronic renal failure have been implicated in other reports, several of our patients received standard doses of gadolinium, and two had transient acute renal failure before diagnosis. Most patients had mild or moderate symptoms. Nephrogenic systemic fibrosis developed in 2.9% of patients undergoing long-term dialysis who received gadolinium-based contrast material but in none of the long-term dialysis patients who did not receive gadolinium-based contrast material.
机译:目的:本研究的目的是在学术医学中心确定肾原性系统性纤维化的发生率及其与肾衰竭的关系以及and基造影剂的使用。材料与方法:检索皮肤病理学数据库以鉴定出诊断为肾原性系统性纤维化的患者。回顾了这些患者的病历。评估了任何基于administration的对比剂给药后的肾功能,以及患者的预后。分别审查了接受长期透析的患者数据库,以确定其中有多少人接受了and治疗,以及这些患者中肾原性系统性纤维化的发生频率。结果:发现1999年11月15日至2006年12月31日之间有29例患有肾原性系统性纤维化。已知在诊断之前已对其中25例患者使用了based基造影剂。所有29例患者的肾功能均受损(27例患有慢性肾衰竭,其中2例患有急性肾衰竭)。通常很难确定基于lin的对比剂给药与症状发作之间的时间关系。只有八名患者有严重的发病率。接受g undergo造影剂的414位接受长期透析的患者中,有12位(2.9%)发生了肾源性系统性纤维化。结论:我们证实肾源性系统性纤维化与基于contrast的造影剂管理之间存在密切联系。尽管在其他报道中还涉及了使用高剂量的and和发生慢性肾功能衰竭,但我们的一些患者接受了标准剂量的,,另外两名患者在诊断之前出现了短暂性急性肾功能衰竭。大多数患者有轻度或中度症状。接受%基造影剂的接受长期透析的患者中有2.9%发生肾源性系统性纤维化,但未接受g基造影剂的长期透析患者中​​未发生。

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