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肝脏病与肾脏病之间有密切关系,包括同一病原(如乙型肝炎病毒)可使肝肾同时受损,因而在肝病时可并发免疫复体性肾炎。此外在肝病时可引起肾间质—小管损害,继发肾小管性酸中毒,或肝硬化时解毒功能减低和血液动力学改变引起肾功能衰竭,出现肝肾综合症。一、肝病继发肾小管性酸中毒尿酸化缺陷曾被发现于某些肝硬化病人中,除肝豆状核变性(Wilson病)时可伴有肾小管性酸中毒(RTA)外,近年来在慢性活动性肝炎、原发性胆汁性肝硬化中见到RTA。发病机理:关于肝病时RTA的发病饥理尚不清楚,RTA可以是一种全身性自身免疫疾病的肾脏表现,从这些病人的肾活检中显示远曲小管和间质组织被致敏的单核细胞和自身抗体所损害,其特点相似于尸体供肾移植后,遭受免疫损害的RTA,并发现自身免疫肝病与肾的Tamm-Horsfall蛋白有交叉反应,根据免疫萤光定位,这些蛋白是存在于
Liver disease and kidney disease are closely related, including the same pathogen (such as hepatitis B virus) can cause liver and kidney damage at the same time, so in liver disease may be complicated by immune complex nephritis. In addition, liver disease can cause renal interstitial - tubule damage, secondary renal tubular acidosis, or liver cirrhosis detoxification function and hemodynamic changes caused by renal failure, hepatorenal syndrome. First, the liver disease secondary to renal tubular acidosis Uric acid deficiency has been found in some patients with cirrhosis, in addition to Wilson’s disease (Wilson’s disease) may be associated with renal tubular acidosis (RTA), in recent years RTA is seen in chronic active hepatitis and primary biliary cirrhosis. Pathogenesis: The incidence of RTA in liver disease is unclear, and RTA can be a renal manifestation of systemic autoimmune disease. Far from the renal biopsies of these patients, distal tubules and interstitial tissue are sensitized by mononuclear Cells and autoantibodies that are similar in features to RTA immunocompromised after autologous donor kidney transplantation and have found that autoimmune liver disease cross-reacts with the Tamm-Horsfall protein in the kidney and that these proteins are present in immunofluorescent localization