Clinical and Pathological Analysis of Nutcracker Syndrome Complicated with Kidney Disease

REN Hong-rong; ZHANG Ai-ping; JIANG Xiao-yu; WANG Yan-xia

doi:10.3969/j.issn.1002-3429.2016.04.027

Abstract：Objective To investigate mutual relationship between nutcracker syndrome and primary glomerular dis-ease. Methods 46 patients with nutcracker syndrome (NCS group) during August 2006 to April 2015, including 21 patients of glomerular nephritis complicated with nutcracker syndrome were selected as combined group and 25 cases of nutcracker syn-drome as pure group (n=25). At the same time, 53 cases of non-NCS glomerular diseases confirmed by biopsy with the same age and gender were selected as control group. The clinical and pathological data of these cases were analyzed retrospectively. Results Compared with control group in NCS group, body mass index, mean arterial pressure, 24 h urine protein quanta, and polymorphic urine red blood cell proportion were reduced with statistically significant difference ( P<0. 05 ) . Compared with pure group in the combined group, 24 h urine protein quanta was high, red cell morphology of urinary was uniform, and the difference was statistically significant (P<0. 05);ultrasound examination showed that difference between the two groups had no statistical significance, such as in angle of SMA and AA, LRV narrow diameter, LRV near the renal hilum diameter and the ratio between of the two groups (P>0. 05). Pathological examination showed that these were 10 cases of immunoglob-ulin A (IgA) nephropathy (47. 6%), 8 cases of mesangial proliferative glomerulonephritis (38. 1%), 2 cases of mild lesions nephropathy (9. 5%), 1 case of capillaries proliferative glomerulonephritis (4. 8%) in combined group. Conclusion NCS tends to occur in slim patients. NCS patients with glomerular hematuria or moderately and severe proteinuria as well as without renal biopsy contraindications, should be suspected as having glomerular disease, and should undergo renal biopsy as soon as possible in order to make definitive diagnosis and receive correct treatment in time. In case of NCS complicated with idiopathic glomerular disease, the incidence of IgA nephropathy is high.