Department of Pediatrics, Nhi Dong 2 Hospital-Grall, University Pham Ngoc Thach, 86/2 Thanh Thai Quan 10, Ho Chi Minh City, Vietnam.
Pediatr Nephrol. 2010 May;25(5):935-40. doi: 10.1007/s00467-009-1424-2. Epub 2010 Feb 11.
The aim of this study was to report on the clinical characteristics and outcomes of Belgian children with chronic kidney disease (CKD). Between 2001 and 2005, we followed 143 new successive patients younger than 20 years of age with a glomerular filtration rate of <60 ml/min/1.73 m(2) prospectively in a Belgian department of pediatric nephrology. The incidence of diagnosed CKD was 11.9 per million child population (pmcp), and the incidence of renal replacement therapy was 6.2 pmcp. There were 67% patients in CKD stage 3, 19% in CKD stage 4 and 14% in CKD stage 5. Patients with congenital anomalies of the kidney and urinary tract (CAKUTs), hereditary diseases and glomerular diseases were diagnosed at a median age of 1, 2 and 10 years, respectively. CAKUTs were the main causes of CKD, accounting for 59% of all cases. After 3, 4 and 5 years of follow-up, 27, 31 and 38% of patients treated conservatively, respectively, reached end-stage renal failure (ESRF). The progression rate to ESRF was eightfold higher in patients with CKD stage 4 than in those with CKD stage 3. Among our patient group, hereditary diseases progressed more rapidly to ESRF than CAKUTs. Transplantation was performed preemptively in 22% of these children. Infections and cardiovascular diseases were the main causes of death.
本研究旨在报告比利时儿童慢性肾脏病（CKD）的临床特征和结局。2001 年至 2005 年，我们前瞻性地随访了比利时儿科肾脏病学系 143 例年龄小于 20 岁、肾小球滤过率<60 ml/min/1.73 m(2)的新连续患者。诊断为 CKD 的发病率为 11.9/百万儿童（pmcp），接受肾脏替代治疗的发病率为 6.2 pmcp。CKD 分期 3 期患者占 67%，CKD 分期 4 期患者占 19%，CKD 分期 5 期患者占 14%。先天性肾和尿路畸形（CAKUTs）、遗传性疾病和肾小球疾病患者的中位诊断年龄分别为 1、2 和 10 岁。CAKUTs 是 CKD 的主要病因，占所有病例的 59%。保守治疗的患者分别在 3、4 和 5 年后，有 27%、31%和 38%进展至终末期肾衰竭（ESRF）。CKD 分期 4 期患者进展至 ESRF 的速度比 CKD 分期 3 期患者快 8 倍。在我们的患者群体中，遗传性疾病比 CAKUTs 更迅速地进展为 ESRF。这些儿童中有 22%预防性接受了移植。感染和心血管疾病是死亡的主要原因。
