Goldstein Stuart L
Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
Artif Organs. 2003 Sep;27(9):781-5. doi: 10.1046/j.1525-1594.2003.07281.x.
The disease spectrum leading to pediatric renal replacement therapy (RRT) provision has broadened over the last decade. In the 1980s, intrinsic renal disease and burns constituted the most common pediatric acute renal failure etiologies. More recent data demonstrate that pediatric acute renal failure (ARF) most often results from complications of other systemic diseases, resulting from advancements in congenital heart surgery, neonatal care, and bone marrow and solid organ transplantation. In addition, RRT modality preferences to treat critically ill children have shifted from peritoneal dialysis to continuous renal replacement therapy (CRRT) as a result of improvements in CRRT technologies. Currently, multicenter prospective outcome studies for critically ill children with ARF are sorely lacking. The aims of this article are to review the pediatric specific causes necessitating renal replacement therapy provision, with an emphasis on emerging practice patterns with respect to modality and the timing of treatment, and to focus upon the application of the different renal replacement therapy modalities and assessment of the outcome of children with ARF who receive renal replacement therapy.
在过去十年中，导致小儿肾替代治疗（RRT）的疾病谱有所拓宽。在20世纪80年代，原发性肾病和烧伤是小儿急性肾衰竭最常见的病因。最近的数据表明，小儿急性肾衰竭（ARF）最常由其他全身性疾病的并发症引起，这些并发症源于先天性心脏病手术、新生儿护理以及骨髓和实体器官移植技术的进步。此外，由于连续性肾脏替代治疗（CRRT）技术的改进，治疗重症儿童的RRT方式偏好已从腹膜透析转向CRRT。目前，针对患有ARF的重症儿童的多中心前瞻性结局研究严重缺乏。本文的目的是回顾需要进行肾替代治疗的小儿特定病因，重点关注治疗方式和治疗时机方面的新兴实践模式，并着重探讨不同肾替代治疗方式的应用以及接受肾替代治疗的ARF患儿的结局评估。
