Oemar B S, Hoyer P F, Ehrich J H, Offner G, Krohn H P, Brodehl J
Kinderklinik, Medizinischen Hochschule Hannover.
Monatsschr Kinderheilkd. 1989 Jun;137(6):314-20.
From 1976-1987 a total of 26 infants and children with polycystic kidney disease were treated at the Children's Hospital of the Medical School Hannover. 13 of them suffered from infantile recessive polycystic kidney disease (IRPKD), and 13 from adult dominant polycystic kidney disease (ADPKD). IRPKD was diagnosed at a median age of 0.33 years (range 1 day-13 years), ADPKD at 6.0 years (3 days-14 years). Of those with IRPKD two infants died from bacterial infection and two others developed terminal renal insufficiency at the age of 8 years, while the others are living and 1-20 years old. All those suffer from severe arterial hypertension and have reduced renal function, but only 5 developed signs of liver fibrosis. Of those with ADPKD one infant died from sepsis and renal insufficiency, while the others are well and now 2-17 years old. Only one child needs an antihypertensive treatment. The most important criteria to differentiate IRKPD and ADKPD in children are the genetic transmission, age of first manifestation, hypertension and renal function. The prognosis is much more severe in IRPKD than in ADPKD, but is not as infaust in IRPKD as often assumed.
1976年至1987年期间,汉诺威医学院儿童医院共收治了26例患有多囊肾病的婴幼儿和儿童。其中13例患婴儿型隐性多囊肾病(IRPKD),13例患成人显性多囊肾病(ADPKD)。IRPKD确诊时的中位年龄为0.33岁(范围1天至13岁),ADPKD为6.0岁(3天至14岁)。IRPKD患儿中有2例因细菌感染死亡,另有2例在8岁时发展为终末期肾功能不全,其余患儿存活,年龄在1至20岁之间。所有患儿均患有严重的动脉高血压且肾功能减退,但只有5例出现肝纤维化迹象。ADPKD患儿中有1例因败血症和肾功能不全死亡,其余患儿情况良好,现年龄在2至17岁之间。只有1名儿童需要进行抗高血压治疗。儿童IRKPD和ADKPD最重要的鉴别标准是遗传传递、首发年龄、高血压和肾功能。IRPKD的预后比ADPKD严重得多,但不像通常认为的那样对IRPKD极为不利。