慢性肾脏病2～5期患儿264例病因构成分析  

Etiological analysis of 264 cases with chronic kidney disease stage 2 to 5 in children

作　　者：缪千帆 沈茜[1] 徐虹[1] 孙利[1] 汤小山[1] 方晓燕[1] 刘海梅[1] 翟亦晖[1] 毕允力[2] 王翔[2] 陈宏[2] 

机构地区：[1]复旦大学附属儿科医院肾脏风湿科,上海201102 [2]复旦大学附属儿科医院泌尿外科,上海201102

出　　处：《中华儿科杂志》2015年第9期665-669,共5页Chinese Journal of Pediatrics

基　　金：上海市自然科学基金青年项目（12ZR1441300）

摘　　要：目的 总结10年来复旦大学附属儿科医院慢性肾脏病（CKD） 2～5期患儿的病因构成情况.方法 应用复旦大学附属儿科医院住院病历检索系统,检索并收集2004年1月-2013年12月期间复旦大学附属儿科医院住院的符合诊断标准的CKD 2 ～5期患儿264例,统计其首次诊断时年龄、分期,原发病诊断等信息,进行回顾性分析.结果 264例CKD 2 ～5期患儿中首次就诊时2期52例（19.7％）,3期67例（25.4％）,4期52例（19.7％）,5期93例（35.2％）.按照原发病分,依次为：先天性肾脏和尿路畸形（CAKUT） 116例（43.9％）,肾小球疾病61例（23.1％）,遗传性肾病15例（5.7％）,其他14例（5.3％）,病因不明58例（22.0％）.0～3.0岁和＞3.0 ～6.0岁的CKD 2～5期患儿中,分别有57.1％（24/42）及60.0％（30/50）的患儿原发病为CAKUT,＞10.0岁的患儿中,49.2％（30例）为肾小球疾病,32.0％（32例）病因未明.结论 复旦大学附属儿科医院10年来就诊的CKD 2 ～5期患儿的首要病因为CAKUT,其次为肾小球疾病.CAKUT是婴幼儿及学龄前期CKD的重要病因,而较大年龄组的CKD患儿中,则以肾小球疾病为主,另有一部分患儿病因未明.Objective To study and summarize the etiology of children patients with chronic kidney disease （CKD） stage 2 to 5 seen in Children＆#39;s Hospital of Fudan University from Jan.2004 to Dec.2013.Method By complying with the NKF-K/DOQI guidelines,we collected data of 264 cases of children patients with CKD stage 2-5 from Jan.2004 to Dec.2013 in the medical record system of Children＆#39;s Hospital of Fudan University.And we retrospectively analyzed their age and CKD stage at first diagnosis,primary diseases,complications,etc.Result In the collected 264 cases,52 cases （19.7%） were diagnosed at stage 2,67 （25.4%） at stage 3,52 （19.7%） at stage 4 and 93 （35.2%） at stage 5.For disease causes,116 cases （43.9%） had congenital anomalies of the kidney and urinary tract （CAKUT）,61 cases （23.1%） had glomerular disease,15 （5.7%） had hereditary kidney disease,14 （5.3%） had other diseases and in 58 cases （22.0%） the causes of disease were unknown.In the group with age between 0 and 3.0 and 3.1 and 6.0 years,57.1% （24 cases） and 60.0% （30 cases） had primary disease with CAKUT.In the group with age older than 10 years,49.2% （30 cases） had primary disease with glomerular disease and 32.0% （32 cases） with unknown causes.Conclusion The major cause of CKD stage 2-5 in children in our hospital during the last ten years was CAKUT （43.9%）,followed by glomerular disease （23.1%）.The primary diseases of CKD were significantly different between the 2 age groups.CAKUT was more common in infants and preschool children while for adolescents,glomerular disease was the major cause.

关 键 词：肾功能衰竭 慢性 儿童 

分 类 号：R726.9[医药卫生—儿科]