Reimold E W, Don T D, Worthen H G
Pediatrics. 1977 Jun;59 Suppl(6 Pt 2):987-94.
All cases of persistent renal failure in infants less than 1 year of age were reviewed to determine whether the prognosis has improved equally for infants as for adults. During a ten-year period, 52 infants were treated by applying uniform therapy; 28, more than half, were less than 4 weeks old. All cases were separated into two groups; 19 infants without and 33 infants with congenital renal or urinary tract anomalies. In 20 patients of the latter group, additional serious anomalies of other organs were present. The age distribution was strikingly different: in 18 of 21 infants, renal anomalies were present, as diagnosed on the first day of life. In contrast, only 3 of 11 infants, 4 to 12 months old, had urinary tract anomalies. In infants without renal anomalies, renal failure was caused by hypotension or shock in 10 of 19 cases, by pyelonephritis or sepsis un 6 of 19. Of this group, eight infants (42%) recovered completely, nine (47%) died. Death occurred within one to two days of hospitalization in all but three cases, caused by shock or sepsis. In this group medical problems that are amenable to therapy have caused either renal failure or contributed to the infant's death. In infants with renal or urinary tract anomalies, renal failure was caused by renal dysplasia or agenesis in 16 of 33 infants, by urinary tract obstruction in 12 of 33. Only three patients (9%) recovered, all older than 4 months, 20 (61%) died, and 10 are living with signs of chronic renal failure. Death usually occurred within one week of hospitalization and, in 16 of 20, it was caused by renal failure and multiple additional anomalies. The multiplicity and complexity of the congenital anomalies in most instances precluded effective, lifesaving therapy. Renal failure in infants is still a serious disease accompained by a high mortality rate in which therapeutic possibilities are limited. No improvement in prognosis can be expected in the near future. Pediatrics, 59:987-994, 1977, RENAL FAILURE, CONGENITAL RENAL ANOMALIES, INFANT, ISCHEMIC RENAL DAMAGE.
对所有1岁以下婴儿持续性肾衰竭病例进行了回顾，以确定婴儿的预后是否与成人一样得到了同等程度的改善。在十年期间，采用统一疗法治疗了52例婴儿；其中28例，超过半数，年龄小于4周。所有病例分为两组；19例婴儿无先天性肾脏或泌尿道异常，33例婴儿有先天性肾脏或泌尿道异常。在后一组的20例患者中，还存在其他器官的严重异常。年龄分布显著不同：21例婴儿中有18例在出生第一天就被诊断出存在肾脏异常。相比之下，11例4至12个月大的婴儿中只有3例有泌尿道异常。在无肾脏异常的婴儿中，19例中有10例肾衰竭是由低血压或休克引起的，19例中有6例是由肾盂肾炎或败血症引起的。在这组中，8例婴儿（42%）完全康复，9例（47%）死亡。除3例病例外，所有死亡均发生在住院后1至2天内，死因是休克或败血症。在这组中，可通过治疗解决的医疗问题导致了肾衰竭或促成了婴儿死亡。在有肾脏或泌尿道异常的婴儿中，33例中有16例肾衰竭是由肾发育不全或肾缺如引起的，33例中有12例是由泌尿道梗阻引起的。只有3例患者（9%）康复，均超过4个月大，20例（61%）死亡，10例存活但有慢性肾衰竭迹象。死亡通常发生在住院后一周内，20例中有16例是由肾衰竭和多种其他异常引起的。大多数情况下先天性异常的多样性和复杂性使得有效的救命治疗无法进行。婴儿肾衰竭仍然是一种严重疾病，死亡率很高，治疗可能性有限。近期内预后预计不会改善。《儿科学》，第59卷：987 - 994页，1977年，肾衰竭、先天性肾脏异常、婴儿、缺血性肾损伤
