Chantler C, Schärer K, Gilli G, Brunner F P, Gurland H J, Jacobs C, Selwood N H, Wing A J
Acta Paediatr Scand. 1978 Jan;67(1):5-10. doi: 10.1111/j.1651-2227.1978.tb16269.x.
The number of new paediatric patients accepted for treatment by regular dialysis and transplantation increased more slowly than in previous years. Survival in children above 10 years appeared to be better with all modes of therapy than in younger children. The only improvement in survival noted among the different treatments was in patient and graft survival of living donor transplants. A quarter of all children transferred to home dialysis were less than 10 years of age. Nephronophthisis and Henoch-Schönlein nephritis emerged as major primary renal diseases. In 1975 the proportion of retransplants in children rose and living donor grafts from fathers were more common than from mothers. Evening dialysis was practised more frequently in both hospital and home dialysis and rehabilitation in these patients seemed to be better than for those dialysed at other times. Renal osteodystrophy was present in at least half of all children dialysed for more than 1 year. The degree of grouth retardation was affected by sex, chronological age and the primary renal disease. Body height on dialysis and after transplantation progressively reduced in the majority of children. Growth seemed to be more impaired in boys than in girls on dialysis. Bone age advanced faster than height age especially in girls. The pubertal growth spurt was usually delayed and depressed on long-term dialysis and the development of genitalia and pubic hair as well as menarche was retarded.
接受常规透析和移植治疗的新儿科患者数量增长速度比前几年更慢。10岁以上儿童采用所有治疗方式的生存率似乎比年幼儿童更高。在不同治疗方法中,唯一观察到生存率有所改善的是活体供体移植的患者和移植物生存率。所有转为家庭透析的儿童中有四分之一年龄小于10岁。肾单位肾痨和过敏性紫癜性肾炎成为主要的原发性肾脏疾病。1975年,儿童再次移植的比例上升,来自父亲的活体供体移植物比来自母亲的更为常见。在医院和家庭透析中,夜间透析更为频繁,这些患者的康复情况似乎比其他时间透析的患者更好。至少一半接受透析超过1年的儿童存在肾性骨营养不良。生长迟缓的程度受性别、实足年龄和原发性肾脏疾病的影响。大多数儿童在透析时和移植后的身高逐渐降低。透析时男孩的生长似乎比女孩受到的损害更大。骨龄比身高年龄增长得更快,尤其是在女孩中。青春期生长突增在长期透析时通常延迟且受到抑制,生殖器、阴毛发育以及月经初潮均延迟。