Harambat Jérôme, Morin Denis
Département de pédiatrie, Centre de référence maladies rénales rares du Sud-Ouest (SORARE), filière de santé ORKiD, CHU de Bordeaux, Bordeaux, France.
Département de pédiatrie, Centre de référence maladies rénales rares du Sud-Ouest (SORARE), filière de santé ORKiD, CHU de Montpellier, Montpellier, France.
Med Sci (Paris). 2023 Mar;39(3):209-218. doi: 10.1051/medsci/2023027. Epub 2023 Mar 21.
Major advances have been made in the management of children with chronic kidney disease (CKD) over the past 30 years. However, existing epidemiological data mainly relies on registries of chronic kidney replacement therapy. The incidence and prevalence of earlier stages of CKD remain largely unknown, but rare population-based studies suggest that the prevalence of all stages CKD may be as high as 1 % of the pediatric population. Congenital disorders including renal hypodysplasia and uropathy (CAKUT) and hereditary nephropathies account for one-half to two-thirds of childhood CKD cases in high-income countries, whereas acquired nephropathies predominate in developing countries. CKD progression is slower in children with congenital disorders than in those with glomerular nephropathy, and other risk factors for progression have also been identified. Children with CKD have poorer health-related quality of life when compared to healthy children. While survival of children with CKD has continuously improved over time, mortality remains 20 to 30 times higher than in the general pediatric population.
在过去30年里,儿童慢性肾脏病(CKD)的管理取得了重大进展。然而,现有的流行病学数据主要依赖于慢性肾脏替代治疗登记。CKD早期阶段的发病率和患病率仍很大程度上未知,但罕见的基于人群的研究表明,所有阶段CKD的患病率可能高达儿科人群的1%。在高收入国家,包括肾发育不全和尿路病(CAKUT)在内的先天性疾病以及遗传性肾病占儿童CKD病例的二分之一至三分之二,而在发展中国家,后天性肾病占主导。先天性疾病患儿的CKD进展比肾小球肾病患儿慢,并且也已确定了其他进展风险因素。与健康儿童相比,CKD患儿的健康相关生活质量较差。虽然CKD患儿的生存率随着时间不断提高,但死亡率仍比普通儿科人群高20至30倍。