Clinical Analysis Based On 90 Nutcracker Syndrome And Nephroptosis

Objective:Retrospective analysis of clinical characteristics of nutcracker syndrome and Nephroptosis to raise awareness of the diseases.Methods:Age, gender, BMI,24-hr urine protein, urinary red cell morphology and Clinical manifestations data were collected from 90 cases with Nutcracker syndrome and Nephroptosis in the second affiliated hospital of Dalian medical university during February 1998 and January 2010. All the 90 patients including 26 male and 64 female, age:3-69 years, mean (27±13.3) years, duration:two weeks-9 years.Results:A total of 90 patients were analyzed including 32 cases with nutcracker syndrome,38 cases with Nephroptosis and 20 cases with nutcracker syndrome with Nephroptosis. In 38 cases with Nephroptosis, right renal ptosis were dominant (55%),followed by left renal ptosis(37%), both renal ptosis (8%).There wasn't a high incidence age of the patients with Nephroptosis,but 79% of the patients with Nutcracker syndrome occur-red at the age from 10 to 29 years.The ratio of male to female was 1:0.88 inthe patients with Nutcracker syndrome,and 1:2.17 with Nephroptosis. The proportion of diagnosis increased year by year,77% of patients were diagnosed in the last 5 years.BMI of 71% of the patients with Nutcracker syndrome and Nephroptosis was less than 19kg/m2. All the cases observed, hematuria occurred in 35 cases, and 31 cases of them underwent urinary red cell morphology examination, including glomerular hematuria (35.5%), Non-glomerular hematuria(41.9%), Mixed hematuria (22.6%). Of all the 90 patients,33 cases had Proteinuria.16 cases were positive in 40 cases with Orthostatic Proteinuria examine,40% positive rate.49 cases were treated with 24h urinary protein inspection, and≤0.5g (77.6%),> 0.5g (22.4%). Pathological types of 11 patients with renal biopsy showed:IgA nephropathy in 7 cases, HBV-related nephritis in 1 case, minimal change nephropathy in 1 case, membranous nephropathy in 1 case, mesangial proliferative glomerulonephritis in 1 case. The analysis of the clinical data about the renal biopsy patients and Non-renal biopsy patients showed that two groups were significantly different in hematuria, proteinuria, urinary red cell morphology,24-hour urine protein, blood pressure and renal function.They had Statistically significantConclusions:Nutcracker syndrome occurs in young and slim, the incidence rate of male was higher, and Nephroptosis occurs in the slim female. Both can be manifested as hematuria and (or) proteinuria. We should vigilant whether combined with glomerular disease, when certain circumstances, such as red blood cell sizes, various shapes, accompanied by proteinuria or large amount of proteinuria etc. renal biopsy when necessary.