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儿童肾脏病与成人终末期肾病的关系——700 例的流行病学调查。

The relationship between children kidney diseases and adult ESRD--an epidemiological investigation of 700 cases.

机构信息

Department of Pediatrics, West China 2nd University Hospital of Sichuan University , Chengdu , P.R. China.

出版信息

Ren Fail. 2013;35(10):1353-7. doi: 10.3109/0886022X.2013.828262. Epub 2013 Aug 21.

Abstract

BACKGROUND

We planned an epidemic investigation of 700 cases who suffered from chronic renal failure (CRF) to search for the evidence to demonstrate the relationship between children kidney diseases and adult CRF.

METHODS

Seven hundred patients from four hospitals in Chengdu, China, were investigated face-to-face to complete a questionnaire referring to the information of diagnoses, treatment, history and so on. These enumeration count data were analyzed by statistical description.

RESULTS

In 700 patients, there were 402 male and 298 female including 21 children and 679 adults. In the disease spectrum, the unclear accounted for 36.3% of totality. Chronic glomerulonephritis made the top proportion (14.4%) in primary kidney diseases. Diabetic nephropathy (15.3%), hypertensive nephropathy (10.1%), and gouty nephropathy (6%) made the primary proportion in secondary kidney diseases. In 21 children, chronic glomerulonephritis had the highest proportion of 52.4%, followed by nephrotic syndrome (19%), Henoch-Schönlein purpura (9.5%), and urinary tract obstruction (4.8%). Thirty-eight cases developed into kidney diseases during childhood including 21 children mentioned above, in which 17 cases presented CRF in the adult stage. The primary renal diseases are chronic glomerulonephritis (60.5%), purpura nephritis (18.4%), nephrotic syndrome (10.5%), urinary tract obstruction (2.6%), and the unclear (7.9%).

CONCLUSION

The survey showed that there were a high proportion of patients whose causes were unknown, to which attention should be paid. Chronic glomerulonephritis remained the main cause of CRF no matter whether in children or in adults. Purpura during childhood, used to be thought as self-limited, might eventually develop into CRF in adulthood, which caught our eyes.

摘要

背景

我们计划对 700 例慢性肾衰竭(CRF)患者进行流行病学调查,以寻找证据表明儿童肾脏病与成人 CRF 之间的关系。

方法

在中国成都的四家医院,对 700 例患者进行面对面调查,完成了一份涉及诊断、治疗、病史等信息的问卷。这些计数数据采用统计描述进行分析。

结果

在 700 例患者中,男 402 例,女 298 例,包括 21 例儿童和 679 例成人。在疾病谱中,不明原因占总数的 36.3%。原发性肾脏病中以慢性肾小球肾炎占比最高(14.4%)。继发性肾脏病中以糖尿病肾病(15.3%)、高血压肾病(10.1%)和痛风性肾病(6%)占比最高。21 例儿童中,以慢性肾小球肾炎(52.4%)所占比例最高,其次是肾病综合征(19%)、过敏性紫癜(9.5%)和尿路梗阻(4.8%)。有 38 例在儿童期发展为肾脏病,包括上述 21 例儿童,其中 17 例在成人期出现 CRF。原发性肾脏病是慢性肾小球肾炎(60.5%)、紫癜性肾炎(18.4%)、肾病综合征(10.5%)、尿路梗阻(2.6%)和不明原因(7.9%)。

结论

本次调查显示,有相当比例的患者病因不明,值得关注。慢性肾小球肾炎仍是 CRF 的主要病因,无论在儿童还是成人中。儿童时期的紫癜,过去认为是自限性的,可能最终会发展成成人期的 CRF,这引起了我们的关注。

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