臨牀透析 Vol.21 No.4(6-1)


特集名 末期腎不全患者の悪性腫瘍
題名 悪性腫瘍合併症としての腎不全 (1) 腎炎
発刊年月 2005年 04月
著者 田部井 薫 自治医科大学附属大宮医療センター腎臓科
【 要旨 】 悪性腫瘍に合併する腎炎は重要で,60歳以上の膜性腎症には10 - 22%に癌が発見され,肺癌44%,消化管癌 (大腸癌,胃癌) 20%である.Hodgkin病では,その0.4%に微小変化型ネフローゼ症候群を合併し,0.1%に腎アミロイドーシスがみられる.非Hodgkinリンパ腫では膜性腎症,膜性増殖性糸球体腎炎の合併もある.小児のHodgkinリンパ腫でも,1.5%に腎症を認め,腎症を伴うHodgkinリンパ腫は予後不良であるとされている.多発性骨髄腫では64.5%が蛋白尿により発見される.アミロイド蓄積によるアミロイド腎や,light chain deposition disease, heavy chain deposition diseaseなどもみられる.
Theme Malignant Tumors in Patients with End-Stage Renal Failures
Title Malignancy and nephritis
Author Kaoru Tabei Division of Nephrology, First Department of Integrated Medicine, Omiya Medical Center, Jichi Medical School
[ Summary ] Nephrotic syndrome is sometimes associated with various malignancies. In 10 to 22 % of patients with membranous nephropathy over 60 years of age had malignancies, such as lung cancer (44 %) and gastrointestinal cancer (20 %). In Hodgkin's disease, minimal change nephrotic syndrome was seen in 0.4 % of cases, and amyloidosis in 0.1 %. In non-Hodgkin's lymphoma, membranous nephropathy and membranoproliferative glomerulonephritis is sometimes encountered. In childhood, 1.5 % of patients with Hodgkin's lymphoma have nephropathy and have poor prognoses. With multiple myeloma, 64.5 % of cases were found to have proteinuria. In this disease, amyloid nephropathy, light chain deposition disease, and heavy chain deposition disease are also encountered.
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