Riley Alyssa, Gebhard Daniel J, Akcan-Arikan Ayse
Department of Pediatrics, Section of Pediatric Critical Care Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
Curr Cardiol Rev. 2016;12(2):121-31. doi: 10.2174/1573403x12666151119165628.
Acute kidney injury (AKI) is very common in pediatric medical and surgical cardiac patients. Not only is it an independent risk factor for increased morbidity and mortality in the short run, but repeated episodes of AKI lead to chronic kidney disease (CKD) especially in the most vulnerable hosts with multiple risk factors, such as heart transplant recipients. The cardiorenal syndrome, a term coined to emphasize the bidirectional nature of simultaneous or sequential cardiac-renal dysfunction both in acute and chronic settings, has been recently described in adults but scarcely reported in children. Despite the common occurrence and clinical and financial impact, AKI in pediatric heart failure outside of cardiac surgery populations remains poorly studied and there are no large-scale pediatric specific preventive or therapeutic studies to date. This article will review pediatric aspects of the cardiorenal syndrome in terms of pathophysiology, clinical impact and treatment options.
急性肾损伤（AKI）在儿科心脏内科和外科手术患者中非常常见。它不仅是短期内发病率和死亡率增加的独立危险因素，而且AKI的反复发作会导致慢性肾脏病（CKD），尤其是在具有多种危险因素的最脆弱宿主中，如心脏移植受者。心肾综合征这一术语用于强调急性和慢性情况下心脏-肾脏功能障碍同时或相继出现的双向性质，最近在成人中已有描述，但在儿童中鲜有报道。尽管AKI常见且具有临床和经济影响，但心脏手术人群以外的儿科心力衰竭患者中的AKI仍研究不足，迄今为止尚无大规模的儿科特异性预防或治疗研究。本文将从病理生理学、临床影响和治疗选择方面综述心肾综合征的儿科相关内容。
