Acute Renal Failure Clinical And Pathological Type Of Change:a Single Center10Years Comparative Study

Objective To investigate the clinical characteristics and pathological type of inpatients with acute renal failure over the past10years, and to provide data for clinical diagnosis and treatment.Methods21inpatients with acute renal failure (13men,8women;average age42.1±14.3years)from1998to2001and69inpatients with acute renal failure (43men,26women;average age40.5±13.2years)from2008to2011were involved, in whom carried out kidney biopsy. They were divided into the young (<or=35years), the middle-aged (36-59) and the elderly (> or=60years).Results (1) The majority of inpatients with acute renal failure was the young and the middle-aged, were42.9%and38.1%from1998to2001.respectively. Renal pathological types were acute tubular necrosis in4cases, acute tubulointerstitial nephritis9cases (including1case with IgA nephropathy), crescentic nephritis in4cases and4cases of hypertensive renal injury. In9cases of the young patients with acute renal failure, involved acute tubular necrosis in3cases, acute tubulointerstitial nephritis4cases (including1case with mild mesangial proliferative IgA nephropathy), crescentic glomerulonephritis1case, hypertensive renal injury in1case;8cases of the middle-aged patients,including acute tubular necrosis in2cases and acute tubulointerstitial nephritis in2cases and1case of crescentic glomerulonephritis and hypertensive renal injury in3cases;4cases of the elderly patients, including acute tubular necrosis in1case, acute tubulointerstitial nephritis1case and crescentic glomerulonephritis2cases. The young and the middle-aged were42%and42%from2008to2011,respectively.Renal pathological types were acute tubular necrosis in21cases, acute tubulointerstitial nephritis29cases (including6cases with focal proliferative IgA nephropathy,2cases accompanied with mild mesangial proliferative IgA nephropathy), crescentic glomerulonephritis in6cases,6cases of hypertensive renal injury, focal segmental glomerular sclerosis in3cases, hyperplasia hardening IgA nephropathy complicated with ischemic injury in1case, primary amyloidosis kidney in1case,1case of hemolytic uremic syndrome, allergic granulomatous vasculitis in1case. In29cases of the young patients with acute renal failure,including acute tubular necrosis in13cases and acute tubulointerstitial nephritis9cases (including3cases with focal proliferative IgA nephropathy,2cases accompanied with mild mesangial proliferative IgA nephropathy), crescentic nephritis in2cases;2cases of hypertensive renal injury, focal segmental glomerular sclerosis in1case, hemolytic uremic syndrome1case, hyperplasia hardening IgA nephropathy complicated with ischemic injury in1case;29cases of the middle-aged patients, acute tubular necrosis in7cases, acute tubulointerstitial nephritis14cases (including2cases with focal proliferative IgA nephropathy),crescentic glomerulonephritis in2cases,3cases of hypertensive renal injury, focal segmental glomerular sclerosis in1case, primary amyloidosis kidney in1case, Churg-Strauss vasculitis in1cases;11cases of elderly patients, acute tubular necrosis in1cases, acute tubulointerstitial nephritis6cases (including in1patient with focal proliferative IgA nephropathy), crescentic glomerulonephritis2cases, focal segmental glomerular sclerosis in1patients,1case of hypertensive renal injury.(2) The major type of renal pathology was primary acute tubular necrosis and acute tubulointerstitial nephritis, in1998-2001the young and the middle-aged patients were19%and42.9%, in2008-2011the young and the middle-aged patients were30.4%and42%.respectively. The major pathogeny of drug-induced acute renal failure was Chinese herb,which were19%and15.9%in1998-2001and2008-2011, respectively.Conclusions There are no significant differences in clinical characteristics and renal pathology of acute renal failure patients between1998-2001and2008-2011.