Nephron. 2017;136(1):3-49. doi: 10.1159/000457967. Epub 2017 Mar 21.
Hypertension and chronic kidney disease (CKD) have a significant impact on global morbidity and mortality. The Low Birth Weight and Nephron Number Working Group has prepared a consensus document aimed to address the relatively neglected issue for the developmental programming of hypertension and CKD. It emerged from a workshop held on April 2, 2016, including eminent internationally recognized experts in the field of obstetrics, neonatology, and nephrology. Through multidisciplinary engagement, the goal of the workshop was to highlight the association between fetal and childhood development and an increased risk of adult diseases, focusing on hypertension and CKD, and to suggest possible practical solutions for the future. The recommendations for action of the consensus workshop are the results of combined clinical experience, shared research expertise, and a review of the literature. They highlight the need to act early to prevent CKD and other related noncommunicable diseases later in life by reducing low birth weight, small for gestational age, prematurity, and low nephron numbers at birth through coordinated interventions. Meeting the current unmet needs would help to define the most cost-effective strategies and to optimize interventions to limit or interrupt the developmental programming cycle of CKD later in life, especially in the poorest part of the world.
高血压和慢性肾脏病(CKD)对全球发病率和死亡率有重大影响。低出生体重与肾单位数量工作组编写了一份共识文件,旨在解决高血压和CKD发育编程这一相对被忽视的问题。该文件源自2016年4月2日举办的一次研讨会,参会人员包括产科、新生儿科和肾脏病领域国际知名的杰出专家。通过多学科参与,该研讨会的目标是强调胎儿期和儿童期发育与成人疾病风险增加之间的关联,重点关注高血压和CKD,并为未来提出可能的切实可行的解决方案。共识研讨会的行动建议是综合临床经验、共享研究专业知识以及文献综述的结果。这些建议强调,有必要通过协调干预措施,降低低出生体重、小于胎龄儿、早产以及出生时肾单位数量少的情况,从而尽早采取行动,预防日后生活中的CKD和其他相关非传染性疾病。满足当前未得到满足的需求将有助于确定最具成本效益的策略,并优化干预措施,以限制或中断日后生活中CKD的发育编程周期,尤其是在世界上最贫困的地区。