Division of Pediatric Nephrology, Department of Pediatrics, University of New Mexico, Children's Hospital, Albuquerque, New Mexico, USA.
Curr Opin Pediatr. 2010 Apr;22(2):161-9. doi: 10.1097/MOP.0b013e328336ebb0.
The present review provides an overview of the identified risk factors for chronic kidney disease (CKD) progression emphasizing the pediatric population.
Over the past 10 years, there have been significant changes to our understanding and study of preterminal kidney failure. Recent refinements in the measurement of glomerular filtration rate and glomerular filtration rate estimating equations are important tools for identification and association of risk factors for CKD progression in children. In pediatric CKD, lower level of kidney function at presentation, higher levels of proteinuria, and hypertension are known markers for a more rapid decline in glomerular filtration rate. Anemia and other reported risk factors from the pregenomic era require further study and validation. Genome-wide association studies have identified genetic loci that have provided novel genetic risk factors for CKD progression.
With cohort studies of children with CKD becoming mature, they have started to yield important refinements to the assessment of CKD progression. Although many of the traditional risk factors for renal progression will certainly be assessed, such cohorts will be important for evaluating novel risk factors identified by genome-wide studies.
本文重点介绍了儿科人群慢性肾脏病(CKD)进展的相关风险因素,并对其进行了概述。
在过去的 10 年中,我们对终末期肾衰竭的认识和研究发生了重大变化。肾小球滤过率的测量和肾小球滤过率估算方程的最新改进是识别和关联儿童 CKD 进展风险因素的重要工具。在儿科 CKD 中,起病时肾功能水平较低、蛋白尿水平较高和高血压是肾小球滤过率快速下降的已知标志物。贫血和前基因组时代报告的其他风险因素需要进一步研究和验证。全基因组关联研究已经确定了与 CKD 进展相关的新的遗传风险因素。
随着针对 CKD 患儿的队列研究逐渐成熟,它们开始对 CKD 进展的评估进行重要的细化。虽然肯定会评估许多传统的肾脏进展风险因素,但这些队列对于评估全基因组研究确定的新风险因素非常重要。