Steflea R, Stroescu R F, Gafencu M, Chisavu F, Stoicescu E R, Doros G
"Victor Babes" University of Medicine and Pharmacy, XI Pediatrics, Timișoara, Romania.
"Louis Turcanu" Emergency Hospital for Children - Pediatrics, Timișoara, Romania.
Acta Endocrinol (Buchar). 2024 Jul-Sep;20(3):393-400. doi: 10.4183/aeb.2024.393. Epub 2025 May 23.
The underlying mechanisms for endocrine disturbances in patients with kidney alterations are complex.
To provide better longitudinal follow-up of children, especially to check their progress through puberty.
A prospective study was conducted at the "Louis Turcanu" Emergency Hospital for Children in Timisoara, Romania during 01.01.2022- 31.12.2024. The study population included ten pediatric patients with end stage renal disease (ESRD) on hemodialysis. Data were collected from the electronic medical records and included demographic information and relevant laboratory parameters, which reflect the patients' anemia status, inflammation, mineral metabolism and other endocrine abnormalities.
Erythropoietin doses ranged from 87 to 176 units/kg once a week at the beginning of our study, higher than guidelines recommendations. Most patients presented with hemoglobin levels below the normal range which slightly increased over the 3 years period. Vitamin D levels ranged from 8.1 to 55.8 ng/mL. These resulted in a poor control of the mineral bone disease associated with kidney failure.
The loss of kidney function is associated with an impaired control of phosphor-calcium balance, and anemia, growth and pubertal delay in children. This study highlights the need for individualized treatment plans and a multidisciplinary approach in pediatric patients with ESRD.
肾脏改变患者内分泌紊乱的潜在机制很复杂。
为儿童提供更好的纵向随访，尤其是检查他们青春期的进展情况。
2022年1月1日至2024年12月31日期间，在罗马尼亚蒂米什瓦拉的“路易·图尔卡努”儿童医院进行了一项前瞻性研究。研究人群包括10名接受血液透析的终末期肾病（ESRD）儿科患者。数据从电子病历中收集，包括人口统计学信息和相关实验室参数，这些参数反映了患者的贫血状况、炎症、矿物质代谢和其他内分泌异常情况。
在我们研究开始时，促红细胞生成素剂量为每周一次，范围从87至176单位/千克，高于指南推荐剂量。大多数患者的血红蛋白水平低于正常范围，在3年期间略有升高。维生素D水平范围为8.1至55.8纳克/毫升。这些导致与肾衰竭相关的矿物质骨病控制不佳。
肾功能丧失与儿童磷钙平衡控制受损、贫血、生长和青春期延迟有关。本研究强调了对ESRD儿科患者制定个体化治疗方案和采用多学科方法的必要性。
