Shroff Rukshana, Ledermann Sarah
Department of Nephrourology, Great Ormond Street Hospital for Children NHS Trust London, London, WC1 N3JH, UK.
Pediatr Nephrol. 2009 Mar;24(3):463-74. doi: 10.1007/s00467-007-0700-2. Epub 2008 Jan 23.
As the prevalence of children on renal replacement therapy (RRT) increases world wide and such therapy comprises at least 2% of any national dialysis or transplant programme, it is essential that paediatric nephrologists are able to advise families on the possible outcome for their child on dialysis. Most children start dialysis with the expectation that successful renal transplantation is an achievable goal and will provide the best survival and quality of life. However, some will require long-term dialysis or may return intermittently to dialysis during the course of their chronic kidney disease (CKD). This article reviews the available outcome data for children on chronic dialysis as well as extrapolating data from the larger adult dialysis experience to inform our paediatric practice. The multiple factors that may influence outcome, and, particularly, those that can potentially be modified, are discussed.
随着全球接受肾脏替代治疗(RRT)的儿童患病率不断上升,且此类治疗在任何国家的透析或移植项目中至少占2%,小儿肾脏病学家能够就透析对患儿可能产生的预后向家庭提供建议至关重要。大多数儿童开始透析时都期望成功的肾移植是一个可以实现的目标,并且能带来最佳的生存率和生活质量。然而,一些儿童将需要长期透析,或者在慢性肾脏病(CKD)病程中可能会间歇性地再次接受透析。本文回顾了儿童慢性透析的现有预后数据,并从规模更大的成人透析经验中推断数据,以为我们的儿科实践提供参考。文中讨论了可能影响预后的多种因素,尤其是那些可能被改变的因素。