Korean Journal of Nephrology 1987;6(2):304-310.

소아 미소변화형 신증후군환아에서의 신간질 병변의 의의

권순학 , 이지연 , 구자훈 , 곽정식 , 김정일 , 정태호

Abstract

Present study has been conducted to determine the significance of tubulo-interstitial change in children with MCNS (minimal change nephrotic syndrome). Study population consisted 47 children who had been admitted to the Pediatric department of Kyungpook University Hospital from 1976 to 1986,' and diagnosed pathologically as MCNS by tissue obtained from per- cutaneous renal biopsy, and the following results were obtained. Tubulo-interstitial change was present in 13 children (Q+ group) and absent in 34 children (Q group). 0+ group showed slightly lower hemoglobin and higher BUN and creatinine levels than Q group (p<0.01). No difference was noted in ESR, serum protein, albumin and choles- terol between two groups. Urinary N-acetyl-glucosaminidase excretion (nM/ min/mg of creatinine) revealed that; 1. When urinary protein was negative, both groups and controls (taken from 8 healthy children) showed no difference, 2. When urinary protein was 1-2+ and 3-4+ range, both Q+ and Q groups showed significantly elevated values compar- ed to the controls (p<0.05), and though Q+ group showed somewhat higher level than Q group, there was no statistical difference. Response to the steorid therapy showed that initial partial response in Q+ group was seen in 46% compared to 15% in Q group (p<0.05). However, subsequent steroid-dependency was much higher in Q group (74%) compared to Q+ group (31%) (p<0.01). Cytotoxic therapy (cyclophosphamide or chlorambucil) was given in 22 children, and 13 out of 16 children (81%) from Q group showed no relapse within first 6 months or significantly reduced frequency of relapses following therapy, compared to 3 out of 6 children (50%) from Q+ group (p < 0.05).