他克莫司治疗小儿肾病综合征致急性肾衰竭3例报告

发布时间：2018-10-25 16:23

【摘要】：目的探讨他克莫司治疗肾病综合征导致急性肾衰竭的原因。方法回顾分析2012年1月至2015年12月期间因他克莫司治疗肾病综合征导致急性肾衰竭的3例患儿的临床资料。结果 3例患儿中男2例、女1例,年龄分别为3、11和13岁。临床均符合肾病综合征(原发性、单纯型),1例为频复发、2例为继发激素耐药型,肾脏病理均为微小病变。在激素治疗基础上,加用他克莫司后出现急性肾衰竭,均发生于他克莫司治疗后4周内,且前1周内均有感染诱因,经停用或减量他克莫司并对症、支持治疗,肾功能均于2周内恢复正常,其中2例继续应用他克莫司、1例更换为环孢素A。随访10~42个月,3例患儿的肾功能均维持正常。结论在他克莫司治疗儿童肾病综合征的开始4周内,如果合并感染,可能导致可逆性的急性肾衰竭。
[Abstract]:Objective to investigate the causes of acute renal failure caused by tacrolimus in the treatment of nephrotic syndrome. Methods the clinical data of 3 children with acute renal failure due to tacrolimus from January 2012 to December 2015 were retrospectively analyzed. Results among the 3 cases, 2 cases were male and 1 case female, aged 3 11 and 13 years respectively. All cases were in accordance with nephrotic syndrome (primary, simple type), 1 case was recurrent frequently, 2 cases were secondary hormone resistance type, and the renal pathology was all minimal change. On the basis of hormone therapy, acute renal failure occurred after the addition of tacrolimus, which occurred within 4 weeks after tacrolimus treatment. The renal function returned to normal within 2 weeks, 2 of them continued to be treated with tacrolimus and 1 was replaced by cyclosporine A. During 10 ~ 42 months follow-up, the renal function of 3 children remained normal. Conclusion within 4 weeks of tacrolimus treatment in children with nephrotic syndrome, coinfection may lead to reversible acute renal failure.
【作者单位】：北京大学第一医院儿科;
【分类号】：R726.9

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