Lurbe Empar, Alvarez Vicente, Redon Josep
Pediatric Nephrology Unit, Hospital General, University of Valencia, Avenida Tres Cruces s/n, 46014 Valencia, Spain.
J Clin Hypertens (Greenwich). 2004 Apr;6(4):186-91. doi: 10.1111/j.1524-6175.2004.02617.x.
In hypertensive renal disease in children, several risk factors influence the development and the rate of progression of renal damage, including blood pressure levels, proteinuria, lipid disorders, and genetic differences. The impact of blood pressure on renal structures, the most important of the factors, depends not only on blood pressure levels, but also on the persistence of the blood pressure levels over time, mainly during the hours when the patient is resting or sleeping. Abnormal circadian variability is frequently observed in patients with renal damage, and nocturnal blood pressure reduction should be a major therapeutic objective to protect against a decline in renal function. Proteinuria is a guide for establishing targets and for monitoring treatment. It should be reduced as much as possible to obtain maximal renoprotective effect. The role of the other factors, such as lipid disorders and genetics, remains elusive.
在儿童高血压肾病中，有几个危险因素会影响肾损害的发生和进展速度，包括血压水平、蛋白尿、脂质紊乱和基因差异。血压对肾脏结构的影响是这些因素中最重要的，它不仅取决于血压水平，还取决于血压水平随时间的持续性，主要是在患者休息或睡眠的时间段。肾损害患者经常观察到昼夜节律异常，夜间血压降低应成为预防肾功能下降的主要治疗目标。蛋白尿是设定治疗目标和监测治疗的指标。应尽可能降低蛋白尿，以获得最大的肾脏保护作用。其他因素，如脂质紊乱和遗传学的作用仍不明确。
