Clinical And Pathological Analysis Of 31 Cases Of Nutcracker Sydrome With Primary Glomerular Disease

Object:Retrospective analysis of clinical and pathological characteristics of nutcracker sydrome with primary glomerular disease to raise awareness of the diseases.Methods:Basic information(Age,gender,BMI and Clinical manifestations),Clinical test results(24 hr urine protein,urinary red cell morphology,creatinine and so on),ultrasonography and renal pathology data(Light microscopy,immunity and electron microscopy)were collected from 31 cases of NCS with primary glomerular disease in the first affiliated hospital of Guangxi medical university during April 2010 and November 2014.To analysis clinical and pathological data of 31 patients with NCS complicated primary glomerular disease.Ruselts:All 31 patients about nutcracker sydrome with primary glomerular disease occurred at the age from 14 to 57 years old,and the ratio of male to female was 1:2.9.BMI of 58%of the patients was between 19kg/m2 and 25kg/m2.All the cases observed,hematuria occurred in 26 cases,and all of them underwent urinary red cell morphology examination,including glomerular hematuria(26%),non-glomerular hematuria(45%),Mixed hematuria(29%).Of all the 31 patients,27 cases had Proteinuria.All cases were treated with 24h urinary protein inspection,and?0.5g(45%),>0.5g(55%).31 patients were all doing B-ultrasound,and B-ultrasound results suggest that at supine,the inner diameter about left renal vein through the angle between AO and SMA was(0.22±0.22)cm,and the maximum diameter about the angle on the left side was(0.82±0.13)cm,the ratio of(4.27±1.49);Left renal vein was filling well.The analysis of the clinical data about the compression of the left renal vein stenosis degree showed that there is no relationship in hematuria,proteinuria,urinary red cell morphology,24-hour urine protein,blood pressure,BMI and renal function.They had no statistically significant(P>0.05).Pathological types of 31 patients with renal biopsy showed:IgA nephropathy in 21 cases,minimal change nephropathy in 4 cases,focal segmental glomerulosclerosis in 5 cases,endocapillary proliferative glomerulonephritis in 1 case.The analysis of the clinical data about the IgA nephropathy patients and Non-IgA nephropathy patients showed that two groups were significantly different in hematuria,proteinuria,urinary red cell morphology,24-hour urine protein,BMI and renal function.They had Statistically significant(P<0.05).Conclusion:Nutcracker syndrome occurs in young,and can be manifested as hematuria and(or)proteinuria.We should vigilant whether combined with glomerular disease,when certain circumstances,such as amount of recurrent hematuria,red blood cell sizes presented various shapes,accompanied by large amount of proteinuria,kidney dysfunction etc.renal biopsy when necessary.