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台湾小儿常染色体显性多囊肾病的临床特征、治疗和长期预后概述:全国性调查。

Overview of clinical status, treatment, and long-term outcomes of pediatric autosomal-dominant polycystic kidney disease: a nationwide survey in Taiwan.

机构信息

Department of Pediatrics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 97004, Taiwan.

School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan.

出版信息

Sci Rep. 2024 Jul 15;14(1):16280. doi: 10.1038/s41598-024-67250-z.

Abstract

This retrospective study investigated the incidence, medication use, and outcomes in pediatric autosomal-dominant polycystic kidney disease (ADPKD) using Taiwan's National Health Insurance Research Database (NHIRD). A 1:4 matched control group of individuals included in the NHIRD during the same period was used for comparative analyses. A total of 621 pediatric patients were identified from 2009 to 2019 (mean age, 9.51 ± 6.43 years), and ADPKD incidence ranged from 2.32 to 4.45 per 100,000 individuals (cumulative incidence, 1.26-1.57%). The incidence of newly developed hypertension, anti-hypertensive agent use, nephrolithiasis, and proteinuria were significantly higher in the ADPKD group than the non-ADPKD group (0.7 vs. 0.04, 2.26 vs. 0.30, 0.4 vs. 0.02, and 0.73 vs. 0.05 per 100 person-years, respectively). The adjusted hazard ratios for developing hypertension, proteinuria, nephrolithiasis and anti-hypertensive agent use in cases of newly-diagnosed pediatric ADPKD were 12.36 (95% CI 4.92-31.0), 13.49 (95% CI 5.23-34.79), 13.17 (95% CI 2.48-69.98), and 6.38 (95% CI 4.12-9.89), respectively. The incidence of congenital cardiac defects, hematuria, urinary tract infections, gastrointestinal diverticulosis, dyslipidemia, and hyperuricemia were also higher in the ADPKD group. Our study offers valuable insights into the epidemiology of pediatric ADPKD in Taiwan and could help in formulating guidelines for its appropriate management.

摘要

这项回顾性研究使用台湾全民健康保险研究数据库(NHIRD)调查了儿科常染色体显性多囊肾病(ADPKD)的发病率、用药情况和结局。使用同期 NHIRD 中的 1:4 匹配对照组进行比较分析。2009 年至 2019 年期间共确定了 621 例儿科患者(平均年龄 9.51±6.43 岁),ADPKD 的发病率为每 100,000 人 2.32 至 4.45 人(累积发病率为 1.26-1.57%)。ADPKD 组新发生高血压、抗高血压药物使用、肾结石和蛋白尿的发生率明显高于非 ADPKD 组(0.7 vs. 0.04,2.26 vs. 0.30,0.4 vs. 0.02 和 0.73 vs. 0.05 每 100 人年)。新诊断为儿科 ADPKD 患者发生高血压、蛋白尿、肾结石和抗高血压药物使用的调整后危险比分别为 12.36(95%CI 4.92-31.0)、13.49(95%CI 5.23-34.79)、13.17(95%CI 2.48-69.98)和 6.38(95%CI 4.12-9.89)。ADPKD 组先天性心脏缺陷、血尿、尿路感染、胃肠道憩室病、血脂异常和高尿酸血症的发生率也较高。我们的研究提供了台湾儿科 ADPKD 流行病学的有价值的见解,并有助于制定其适当管理的指南。

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