Ingelfinger Julie R, Kalantar-Zadeh Kamyar, Schaefer Franz
Department of Pediatrics, Harvard Medical School, Boston, Mass., USA.
Am J Nephrol. 2016;43(1):58-64. doi: 10.1159/000444509. Epub 2016 Feb 20.
World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, as the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life. Children born early or who are small-for date newborns have relatively increased risk for the development of CKD later in life. Persons with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Successful therapy is feasible for advanced CKD in childhood; there is evidence that children fare better than adults, if they receive kidney replacement therapy including dialysis and transplantation, while only a minority of children may require this ultimate intervention. Because there are disparities in access to care, effort is needed so that those children with kidney disease, wherever they live, may be treated effectively, irrespective of their geographic or economic circumstances. Our hope is that World Kidney Day will inform the general public, policy makers and caregivers about the needs and possibilities surrounding kidney disease in childhood.
2016年世界肾脏日聚焦于儿童期肾病以及可始于儿童早期的成人肾病的前期情况。儿童慢性肾脏病（CKD）与成人不同，因为儿童中最大的诊断类别包括先天性异常和遗传性疾病，而肾小球病和糖尿病相关肾病相对少见。此外，许多急性肾损伤儿童最终会出现后遗症，可能在儿童后期或成年期导致高血压和CKD。早产或足月小样儿在生命后期发生CKD的风险相对增加。出生时具有高危因素及儿童早期有相关病史的人群应密切监测，以便及时发现肾病早期迹象，从而进行有效的预防或治疗。儿童晚期CKD进行成功治疗是可行的；有证据表明，如果接受包括透析和移植在内的肾脏替代治疗，儿童的情况比成人更好，而只有少数儿童可能需要这种最终干预措施。由于在获得医疗服务方面存在差异，需要做出努力，使那些患有肾病的儿童，无论身处何地，无论其地理或经济状况如何，都能得到有效治疗。我们希望世界肾脏日能让公众、政策制定者和护理人员了解儿童肾病的需求和可能性。
