Department of Medicine-Nephrology, University of North Carolina, 7024 Burnett-Womack, CB 7155, Chapel Hill, NC, 27599, USA.
Children's Mercy Kansas City, Kansas City, MO, USA.
Pediatr Nephrol. 2020 Feb;35(2):229-240. doi: 10.1007/s00467-018-4151-8. Epub 2018 Nov 21.
An increasing number of infants with end-stage kidney disease (ESKD) are surviving and receiving renal replacement therapy (RRT). Unique clinical issues specific to this age group of patients influence their short- and long-term outcomes. This review summarizes current epidemiology, clinical characteristics, ethical dilemmas, management concerns, and outcomes of infants requiring chronic dialysis therapy. Optimal care during infancy requires a multidisciplinary team working closely with the patient's family. Nutritional management, infection prevention, and attention to cardiovascular status are important treatment targets. Although mortality rates remain higher among infants on dialysis compared to older pediatric dialysis patients, outcomes have improved over time. Most importantly, infants who subsequently receive a kidney transplant are now experiencing graft survival rates that are comparable to older pediatric patients.
越来越多患有终末期肾病（ESKD）的婴儿得以存活并接受肾脏替代治疗（RRT）。这一年龄组患者特有的独特临床问题影响其短期和长期结局。本文综述了需要慢性透析治疗的婴儿的当前流行病学、临床特征、伦理困境、管理关注点和结局。婴儿期的最佳护理需要多学科团队与患者的家庭密切合作。营养管理、感染预防和关注心血管状况是重要的治疗目标。尽管与大龄儿科透析患者相比，透析婴儿的死亡率仍然较高，但随着时间的推移，结局已经有所改善。最重要的是，随后接受肾移植的婴儿现在的移植物存活率与大龄儿科患者相当。
