van Biljon I, Meyers A M
S Afr Med J. 2015 Apr;105(4):316-9. doi: 10.7196/samj.9532.
Doctors use various guidelines on paediatric chronic kidney disease (CKD) for managing their patients according to the availability of resources. As with adolescent and adult patients, CKD in children can also progress to end-stage renal failure - the time course being influenced by several modifiable factors. Decline in renal failure is best categorised in stages, which determine management and prognosis. Staging is based on three categories, i.e. cause, glomerular filtration rate and proteinuria. Early diagnosis of CKD allows for the institution of renoprotective treatment of modifiable factors and treatment to prevent the development of complications. The two most important modifiable factors that can be treated successfully are hypertension and proteinuria. The objective of this article is to provide information on the diagnosis and treatment of CKD in children. Early identification and treatment of modifiable risk factors of CKD decreases the burden of disease and delays or prevents the need for renal replacement therapy.
医生会根据资源的可获得性,使用各种儿科慢性肾脏病(CKD)指南来管理他们的患者。与青少年和成年患者一样,儿童CKD也会进展到终末期肾衰竭,其病程受多种可改变因素的影响。肾衰竭的进展最好按阶段分类,这决定了治疗和预后。分期基于三个类别,即病因、肾小球滤过率和蛋白尿。CKD的早期诊断有助于对可改变因素进行肾脏保护治疗,并预防并发症的发生。两种最重要且能成功治疗的可改变因素是高血压和蛋白尿。本文的目的是提供有关儿童CKD诊断和治疗的信息。早期识别和治疗CKD的可改变危险因素可减轻疾病负担,并延迟或避免肾脏替代治疗的需求。