First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
Acta Paediatr. 2011 Sep;100(9):1180-4. doi: 10.1111/j.1651-2227.2011.02291.x. Epub 2011 Apr 12.
The prevalence of microalbuminuria (MA) in children and adolescents differs from the one in adults, and it is estimated to be about 5.7-7.3% in boys and 12.7-15.1% in girls. The percentage is greater in smaller age group, whereas a positive association is found between albumin excretion rate and pubertal development stage in nondiabetic subjects. The data so far suggest that impairment of glucose metabolism, obesity-related proatherosclerotic pathways and the impact of haemodynamic load constitute major determinants of albuminuria development in the early years of life. In everyday practice if persistent MA is present at a young age, especially in the setting of diabetes, further investigation of cardiovascular risk factors, a more careful follow-up and dietary/lifestyle interventions are needed.
Although the significance of MA in paediatric essential hypertension has yet to be determined, its role in diabetic children and adolescents is established and albuminuria assessment has been utilized as a screening test for the presence of diabetes-related kidney disease.
儿童和青少年微量白蛋白尿 (MA) 的患病率与成年人不同,据估计,男孩约为 5.7-7.3%,女孩为 12.7-15.1%。年龄越小,这一比例越高,而在非糖尿病患者中,白蛋白排泄率与青春期发育阶段呈正相关。到目前为止的数据表明,葡萄糖代谢受损、肥胖相关的动脉粥样硬化前途径以及血液动力学负荷的影响是生命早期白蛋白尿发展的主要决定因素。在日常实践中,如果在年轻时(尤其是在糖尿病的情况下)持续存在微量白蛋白尿,则需要进一步调查心血管危险因素,更仔细地随访以及饮食/生活方式干预。
尽管微量白蛋白尿在儿科原发性高血压中的意义尚未确定,但它在糖尿病儿童和青少年中的作用已得到确立,并且白蛋白尿评估已被用作筛查糖尿病相关肾脏疾病的检测手段。