Cadnapaphornchai Melissa A
Children's Hospital Colorado, University of Colorado Denver, Aurora, Colorado, USA.
Curr Opin Pediatr. 2015 Apr;27(2):193-200. doi: 10.1097/MOP.0000000000000195.
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disease, affecting one in 500 individuals. The cardinal manifestation of ADPKD is progressive cystic dilatation of renal tubules with kidney enlargement and progression to end-stage renal disease in approximately half of cases by 60 years of age. Although previously considered a condition of adults, it is clear that children and young adults are subject to the complications of ADPKD.
It has been increasingly recognized that interventions early in life are necessary in order to confer the best long-term outcome in this common condition. Therefore, it is imperative for pediatricians to recognize the manifestations and complications of this disease. Until recently ADPKD management focused on general principles of chronic kidney disease. However, several recent clinical trials in children and adults with ADPKD have focused on disease-specific therapies.
This review will highlight the clinical manifestations, diagnosis, and appropriate management of ADPKD in childhood and will review recent relevant clinical trials in children and adults with this condition.
常染色体显性多囊肾病(ADPKD)是最常见的遗传性肾病,每500人中就有1人患病。ADPKD的主要表现是肾小管进行性囊性扩张,肾脏增大,约半数患者在60岁时会进展为终末期肾病。尽管该病以前被认为是成人疾病,但显然儿童和年轻人也会出现ADPKD的并发症。
人们越来越认识到,为了在这种常见疾病中获得最佳长期预后,早期干预是必要的。因此,儿科医生必须认识到这种疾病的表现和并发症。直到最近,ADPKD的管理还集中在慢性肾病的一般原则上。然而,最近针对儿童和成人ADPKD的几项临床试验都集中在疾病特异性治疗上。
本综述将重点介绍儿童ADPKD的临床表现、诊断和适当管理,并回顾最近针对患有这种疾病的儿童和成人的相关临床试验。