Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
The incidence of certain types of glomerular diseases is different in the elderly as compared with younger patients. Many different histologic appearances can be identified; however, membranous nephropathy is the most common type. Underlying malignancy has been thought to be responsible for 5 to 10 percent of cases of membranous nephropathy in adults, with the highest risk in patients over age 60. A solid tumor such as carcinoma of the lung or colon is most frequently involved. It is presumed that tumor antigens are being deposited in the glomeruli, which is followed by antibody deposition and complement activation, leading to epithelial cell and basement membrane injury and proteinuria due to the associated increase in glomerular permeability. In the present study, 33 patients aged over 60 with nephrotic syndrome were analyzed. Fourteen (42%) patients had membranous nephropathy, three of them with underlying malignancy.Incidencija pojedinih tipova glomerulonefritisa u starijih osoba razlikuje se u usporedbi s mlađim bolesnicima. U starijih osoba mogu se dijagnosticirati različiti oblici glomerulonefritisa, no najčešća je membranska nefropatija. Ovaj oblik glomerulonefritisa je u 5% do 10% bolesnika povezan s malignim tumorom. Najčešći oblici malignih tumora udruženih s membranskom nefropatijom su karcinomi pluća i kolona. Pretpostavlja se da se tumorski antigen odlaže u glomerulima, što izaziva taloženje protutijela i aktiviranje komplementa. To pak izaziva oštećenje epitelnih stanica i bazalne membrane glomerula te proteinuriju. U radu je analizirano 33 bolesnika s nefrotskim sindromom. Svi su bolesnici bili stariji od 60 godina. Membranska nefropatija je dijagnosticirana u 14 (42%) bolesnika, a kod troje bolesnika je ovaj oblik glomerulonefritisa bio udružen s malignom bolešću
