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慢性肾脏病患儿向成人肾脏病的过渡

Pediatric to Adult Nephrology Transition in CKD.

作者信息

Shi Vivian, Jang Alex, Copp Hillary, Ku Elaine

机构信息

Division of Nephrology, Department of Medicine and Pediatrics, Stanford University, Palo Alto, California.

Department of Urology, University of California San Francisco, San Francisco, California.

出版信息

Kidney360. 2025 Apr 1;6(4):663-670. doi: 10.34067/KID.0000000762. Epub 2025 Mar 7.

Abstract

CKD affects roughly 10% of the general population. Some adults with CKD were diagnosed with their condition during childhood. Because early CKD is often asymptomatic, obtaining reliable estimates of the true incidence of pediatric CKD (onset before age 18 years) is difficult due to the lack of routine screening for disease in children. With advancements in health care ( e.g ., antenatal imaging and genetic testing) and improved survival outcomes for premature infants and children with complex care needs, a growing number of children with CKD will eventually transfer their care to adult specialists. The purpose of this review is to provide a practical summary of the challenges in the transition and transfer of care process for patients with nondialysis requiring CKD, highlight differences in pediatric and adult care practices based on our experiences, and identify best practices. We will review both practitioner-related and patient-related challenges, as well as the unique health care needs of children with CKD during the transfer of care. We will also provide an overview of the transition and transfer of care for common causes of CKD in children that are less common in adults, such as congenital abnormalities of the kidney and urinary tract.

摘要

慢性肾脏病(CKD)影响着约10%的普通人群。一些成年CKD患者在儿童时期就被诊断出患有该病。由于早期CKD通常没有症状,且缺乏针对儿童疾病的常规筛查,因此很难获得小儿CKD(18岁之前发病)真实发病率的可靠估计。随着医疗保健的进步(例如产前成像和基因检测)以及早产和有复杂护理需求儿童的生存结局得到改善,越来越多的CKD儿童最终将转由成人专科医生护理。本综述的目的是对非透析需求CKD患者护理过渡和转诊过程中的挑战进行实用总结,根据我们的经验突出儿科和成人护理实践的差异,并确定最佳实践。我们将审视与从业者和患者相关的挑战,以及CKD儿童在护理转诊期间独特的医疗保健需求。我们还将概述儿童CKD常见病因(在成人中不太常见,如肾脏和尿路先天性异常)的护理过渡和转诊情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faa8/12045502/e0c79eb64090/kidney360-6-663-g001.jpg

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