严重慢性肾脏病婴儿的长期预后。
Long-term outcome of infants with severe chronic kidney disease.
机构信息
Renal Office, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK.
出版信息
Clin J Am Soc Nephrol. 2010 Jan;5(1):10-7. doi: 10.2215/CJN.05600809. Epub 2009 Nov 12.
BACKGROUND AND OBJECTIVES
In 2000, we reported the outcome of 101 children with a GFR <20 ml/min per 1.73 m2 at 0.3 yr of age (range 0.0 to 1.5 yr). Long-term data on such young children are scarce.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Mortality, treatment modalities, and growth were reanalyzed 9.9 yr later.
RESULTS
Of the 101 patients, 28 died and three were lost to follow-up during 13.90 yr (range 0.03 to 22.90 yr). One-, 2-, 5-, 10-, 15-, 20-, and 22-yr survivals were 87, 81, 77, 75, 73, 72, and 64%, respectively. Fifty-one children had comorbidities. Sixty-six percent were tube fed for 1.7 yr (range 0.1 to 6.9 yr), 37% had a gastrostomy, and 13% had a Nissen fundoplication. Mean height SD score (SD) was -0.42 (2.33) at birth (n = 40), -2.07 (1.34) at 0.5 (n = 62), -1.93 (1.38) at 1 (n = 72), -1.14 (1.14) at 5 (n = 67), -1.04 (1.15) at 10 (n = 62), -1.84 (1.32) at 15 (n = 40), and -1.68 (1.52) at age > or =18 yr (n = 32). Comorbidities adversely influenced growth (P < 0.01) and final height (P = 0.02): Mean height SD score (SD) was -1.16 (1.38) in otherwise normal adults.
CONCLUSIONS
Growth and final height in infants with severe chronic kidney disease are influenced by comorbidity. Intensive feeding and early transplantation resulted in a mean adult height within the normal range in patients without comorbidities. Overall mortality is comparable to that of older children.
背景与目的
2000 年，我们报道了 101 例肾小球滤过率（GFR）<20ml/min/1.73m2 的患儿在 0.3 岁时的结果（范围为 0.0 至 1.5 岁）。对于如此年幼的儿童，长期数据非常有限。
设计、设置、参与者和测量方法：9.9 年后重新分析了死亡率、治疗方式和生长情况。
结果
在 13.90 年（范围为 0.03 至 22.90 年）期间，101 例患者中有 28 例死亡，3 例失访。1、2、5、10、15、20 和 22 年的存活率分别为 87%、81%、77%、75%、73%、72%和 64%。51 例患儿合并症。66%的患儿经口管饲喂养 1.7 年（范围为 0.1 至 6.9 年），37%行胃造口术，13%行 Nissen 胃底折叠术。40 例患儿出生时平均身高标准差评分（SD）为-0.42（2.33），62 例患儿 0.5 岁时为-2.07（1.34），72 例患儿 1 岁时为-1.93（1.38），67 例患儿 5 岁时为-1.14（1.14），62 例患儿 10 岁时为-1.04（1.15），40 例患儿 15 岁时为-1.84（1.32），32 例患儿>或=18 岁时为-1.68（1.52）。合并症对生长（P<0.01）和最终身高（P=0.02）有不良影响：无合并症的成人平均身高标准差评分（SD）为-1.16（1.38）。
结论
严重慢性肾脏病婴儿的生长和最终身高受合并症影响。强化喂养和早期移植使无合并症患者的成年平均身高处于正常范围内。总体死亡率与年龄较大的儿童相当。
Zotero 插件