Abstract:

【Abstract】Objective:To investigate the clinical features of osteonecrosis of the femoral head (ONFH) in patients with idiopathic primary glomerulopathy nephrotic syndrome. Methods:A retrospective analysis of outpatients from January 2009 to December 2013 with ONFH the clinical data of follow-up. Results:The incidence of ONFH in 3796 idiopathic primary glomerulopathy nephrotic syndrome patients which include FSGS, IgM nephropathy and minimal change nephropathy was 2.4%. 80.4% of the ONFH group was diagnosed within the first 3 years of corticosteroid therapy. Multiple factor logistic regression analysis revealed that hypoproteinemia was the risk factor of ONFH (P<0.05).There was no significant difference between two groups in glucocorticoid therapy response,the recurrence frequency of nephropathy and accumulative dosage of glucocorticoid (P>0.05).Preventive use of vitamin D and calcium can not reduce the occurrence of ONFH. There was no difference in sex, age, 24-hour urine albumin excretion, hemoglobin, blood platelet,uric acid,triglyceride,total cholesterol, LDL-C ,the ratio LDL-C to HDL-C, blood phosphorus between the two groups(P>0.05).Conclusions: The incidence of ONFH in patient with primary glomerulopathy nephrotic syndrome was 2.4%.The ONFH has the highest occurrence within 3 years of Glucocorticoid therapy. Hypoproteinemia is the risk factor with ONFH. There was no significant difference between two groups in glucocorticoid therapy response,the recurrence frequency of nephropathy and accumulative dosage of glucocorticoid . The incidence of ONFH in patients with primary glomerulopathy nephrotic syndrome are more likely to have such clinical features as low serum albumin and blood cacium, high serum fibrinogen .Preventive use of vitamin D and calcium can not reduce the occurrence of ONFH.They should do MRI test of the hip joint routinely when the time of glucocorticoid treatment for 5 months.

Key words: primary glomerulopathy, nephritic syndrome, osteonecrosis of the femoral head, glucocorticoid