Eastern Carolina University Brody School of Medicine, Greenville, NC, USA.
Eastern Carolina University Brody School of Medicine, Greenville, NC, USA.
J Natl Med Assoc. 2022 Jun;114(3S2):S50-S55. doi: 10.1016/j.jnma.2022.05.002. Epub 2022 May 31.
Chronic Kidney disease (CKD) is a major public health problem associated with increased health costs, morbidity, and mortality. There is a 30-fold higher mortality rate and severely impaired quality of life in children with chronic kidney disease (CKD), requiring dialysis or kidney transplant compared to the aged-match general population. The early diagnosis and treatment of pediatric CKD can reverse, delay or prevent progression to advanced kidney disease. It is worth noting that CKD with rapid progression, which carries a poor prognosis, is more common in African American children. Thus, the development of a universal pediatric CKD screening program for high-risk children can be vital for social equity. The disparity in prevalence and severity of CKD is likely due to a complex interaction between biological and nonbiological risk factors that influence the development and progression of CKD in children of African descent. For example, high-risk alleles in the gene encoding for apolipoprotein L1 (APOL1) have been recognized as the most important factor in the high incidence of some chronic kidney diseases in African Americans. In this review, we will focus on the trends in the incidence of pediatric CKD and management strategies aimed at enhancing health outcomes and reducing disease progression.
慢性肾脏病（CKD）是一个主要的公共卫生问题，与医疗费用增加、发病率和死亡率上升有关。与年龄匹配的普通人群相比，患有慢性肾脏病（CKD）的儿童的死亡率高出 30 倍，生活质量严重受损，需要透析或肾移植。早期诊断和治疗儿童 CKD 可以逆转、延缓或预防其进展为晚期肾病。值得注意的是，进展迅速的 CKD 预后较差，在非裔美国儿童中更为常见。因此，为高危儿童制定普遍的儿科 CKD 筛查计划对于社会公平至关重要。CKD 的流行率和严重程度的差异可能是由于生物和非生物风险因素之间的复杂相互作用，这些因素影响非洲裔儿童 CKD 的发生和进展。例如，载脂蛋白 L1（APOL1）基因编码的高危等位基因已被认为是非裔美国人某些慢性肾脏病高发的最重要因素。在这篇综述中，我们将重点关注儿科 CKD 的发病率趋势和旨在提高健康结果和减少疾病进展的管理策略。
