Journal of Clinical Pediatrics ›› 2022, Vol. 40 ›› Issue (2): 155-159.doi: 10.12372/jcp.2022.21e1093
• Continuing Medical Education • Previous Articles
ZHANG Hongwen
Received:2021-07-26
Published:2022-02-15
Online:2022-02-11
ZHANG Hongwen. Diagnostic approach on childhood renal dysfunction[J].Journal of Clinical Pediatrics, 2022, 40(2): 155-159.
"
| 肾小球疾病 |
|---|
| 原发性:IgA肾病、链球菌感染后肾小球肾炎、非链球菌感染后肾小球肾炎、肾病综合征等 |
| 继发性:狼疮性肾炎、紫癜性肾炎、ANCA相关性血管炎、溶血尿毒综合征、遗传代谢性疾病继发肾小球损害等 |
| 遗传性:Alport综合征、各种遗传性肾病综合征、遗传代谢性疾病累及肾小球等 |
| 肾小管疾病 |
| 原发性:特发性间质性肾炎等 |
| 继发性:感染、药物、毒物、糖尿病等 |
| 遗传性:Dent病、Lowe综合征、Gitelman综合征、Bartter综合征、Fanconi综合征等 |
| 肾血管疾病 |
| 原发性:大动脉炎、肾动脉狭窄等 |
| 继发性:血栓、血管瘘、血管瘤等 |
| 遗传性:纤维肌性发育不良等 |
| 囊性肾脏病 |
| 原发性:多囊性肾发育不良等 |
| 继发性:长期低钾血症、酸中毒等 |
| 遗传性:常染色体显性遗传性多囊肾、常染色体隐性遗传性多囊肾、肾单位肾痨等 |
| 肾脏和泌尿道先天畸形(CAKUT) |
| 环境因素:主要包括母亲饮食、疾病和药物/毒品/酒精应用等 |
| 遗传因素:单基因遗传约占10%,拷贝数变异约占16% |
| 其他 |
| 反流性肾病、肾结核、肾脏肿瘤等 |
"
| 畸形类型 | 病 因 | 定 义 |
|---|---|---|
| 肾脏数目 | 肾缺如(renal agenesis) | 单侧或双侧,肾脏和流出道未形成 |
| 肾脏大小和形态 | 肾发育不全(renal hypoplasia) | 单侧或双侧,肾脏外形正常,但体积小、肾单位数目减少 |
| 肾发育不良(renal dysplasia) | 单侧或双侧,肾脏外形和组织分化异常,肾单位数目减少 | |
| 多囊性肾发育不良(MCDK) | 肾发育不良伴多囊性病变,肾脏外形异常 | |
| 肾脏位置 | 马蹄肾(horseshoe kidney) | 双侧肾脏后部融合形成马蹄样外形 |
| 异位/盆腔肾(ectopic/pelvic kidney) | 肾脏位置异常,通常位于盆腔 | |
| 流出道畸形 | 肾盂输尿管连接部梗阻(UPJO) | 单侧或双侧,肾脏和输尿管连接部梗阻,阻碍了肾盂的尿液引流入输尿管 |
| 膀胱输尿管连接部梗阻(UVJO) | 单侧或双侧,输尿管和膀胱连接部梗阻,阻碍了输尿管的尿液引流入膀胱 | |
| 膀胱输尿管反流(VUR) | 单侧或双侧,膀胱输尿管连接部缺陷,导致尿液从膀胱反流进入输尿管 | |
| 双集合系统(DCS) | 单侧或双侧,输尿管和肾盂重复,可伴随重复肾;流出道系统反流或梗阻 | |
| 巨输尿管(megaureter) | 单侧或双侧,输尿管扩张导致尿液流出障碍 | |
| 后尿道瓣膜(PUV) | 后尿道瓣膜形成,阻碍了膀胱尿液排出,仅限于男性 |
| [1] |
Khwaja A. KDIGO clinical practice guidelines for acute kidney injury[J]. Nephron, 2012, 120(4):c179-c184.
doi: 10.1159/000339789 |
| [2] |
Shalaby MA, Sawan ZA, Nawawi E, et al. Incidence, risk factors, and outcome of neonatal acute kidney injury: a prospective cohort study[J]. Pediatr Nephrol, 2018, 33(9):1617-1624.
doi: 10.1007/s00467-018-3966-7 |
| [3] |
Gaitonde DY, Cook DL, Rivera IM. Chronic kidney disease: detection and evaluation[J]. Am Fam Physician, 2017, 96(12):776-783.
pmid: 29431364 |
| [4] |
Barry R, James MT. Guidelines for classification of acute kidney diseases and disorders[J]. Nephron, 2015, 131(4):221-226.
doi: 10.1159/000441425 |
| [5] | Kidney Disease: Improving Global Outcomes Hepatitis CWG. KDIGO 2018 clinical practice guideline for the prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease[J]. Kidney Int Suppl (2011), 2018, 8(3):91-165. |
| [6] | National Kidney F. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification[J]. Am J Kidney Dis, 2002, 39(2 Suppl 1):S1-S266. |
| [7] |
Chawla LS, Bellomo R, Bihorac A, et al. Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup[J]. Nat Rev Nephrol, 2017, 13(4):241-257.
doi: 10.1038/nrneph.2017.2 |
| [8] |
Akbari A, Clase CM, Acott P, et al. Canadian Society of Nephrology Commentary on the KDIGO clinical practice guideline for CKD evaluation and management[J]. Am J Kidney Dis, 2015, 65(2):177-205.
doi: 10.1053/j.ajkd.2014.10.013 pmid: 25511161 |
| [9] | 张宏文, 丁洁. 遗传性肾病综合征的基因诊断[J]. 临床儿科杂志, 2011, 29(10):990-994. |
| [10] | 崔洁媛, 张宏文. 肾单位肾痨及其相关纤毛病研究进展[J]. 中国生育健康杂志, 2017, 28(2):195-197. |
| [11] |
Palevsky PM, Liu KD, Brophy PD, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for acute kidney injury[J]. Am J Kidney Dis, 2013, 61(5):649-672.
doi: 10.1053/j.ajkd.2013.02.349 pmid: 23499048 |
| [12] | 何国华, 张宏文, 王芳, 等. 尿α1微球蛋白与微量白蛋白比值诊断Dent病临床价值研究[J]. 中国实用儿科杂志, 2017, 32(5):371-373. |
| [13] | 张宏文, 张琰琴, 刘晓宇, 等. Dent 病6例临床诊治分析[J]. 临床儿科杂志, 2016, 34(6):418-420. |
| [14] |
Murugapoopathy V, Gupta IR. A primer on congenital anomalies of the kidneys and urinary tracts (CAKUT)[J]. Clin J Am Soc Nephrol, 2020, 15(5):723-731.
doi: 10.2215/CJN.12581019 |
| [15] |
Kohl S, Habbig S, Weber LT, et al. Molecular causes of congenital anomalies of the kidney and urinary tract (CAKUT)[J]. Mol Cell Pediatr, 2021, 8(1):1-6.
doi: 10.1186/s40348-021-00111-1 |
| [16] |
Dyck RF, Karunanayake C, Pahwa P, et al. Congenital anomalies of the kidney and urinary tract (CAKUT): an emerging relationship with pregestational diabetes mellitus among first nations and non-first nations people in saskatchewan-results from the DIP: ORRIIGENSS project[J]. Can J Diabetes, 2021, 45(4):346-354.
doi: 10.1016/j.jcjd.2020.10.004 |
| [17] |
Ishiwa S, Sato M, Morisada N, et al. Association between the clinical presentation of congenital anomalies of the kidney and urinary tract (CAKUT) and gene mutations: an analysis of 66 patients at a single institution[J]. Pediatr Nephrol, 2019, 34(8):1457-1464.
doi: 10.1007/s00467-019-04230-w pmid: 30937553 |
| [18] |
Rao J, Liu X, Mao J, et al. Genetic spectrum of renal disease for 1001 Chinese children based on a multicenter registration system[J]. Clin Genet, 2019, 96(5):402-410.
doi: 10.1111/cge.v96.5 |
| [19] |
Vivante A, Hildebrandt F. Exploring the genetic basis of early-onset chronic kidney disease[J]. Nat Rev Nephrol, 2016, 12(3):133-146.
doi: 10.1038/nrneph.2015.205 pmid: 26750453 |
| [20] |
Harambat J, van Stralen KJ, Kim JJ, et al. Epidemiology of chronic kidney disease in children[J]. Pediatr Nephrol, 2012, 27(3):363-373.
doi: 10.1007/s00467-011-1939-1 pmid: 21713524 |
| [21] |
Navaneethan SD, Zoungas S, Caramori ML, et al. Diabetes management in chronic kidney disease: synopsis of the 2020 KDIGO clinical practice guideline[J]. Ann Intern Med, 2021, 174(3):385-394.
doi: 10.7326/M20-5938 pmid: 33166222 |
| [22] |
Kidney Disease: Improving Global Outcomes Blood Pressure Work G. KDIGO 2021 clinical practice guideline for the management of blood pressure in chronic kidney disease[J]. Kidney Int, 2021, 99(3S):S1-S87.
doi: 10.1016/j.kint.2020.11.003 |
| [23] |
Cianciolo G, Cappuccilli M, Tondolo F, et al. Vitamin D effects on bone homeostasis and cardiovascular system in patients with chronic kidney disease and renal transplant recipients[J]. Nutrients, 2021, 13(5):1-22.
doi: 10.3390/nu13010001 |
| [1] | LIN Jinfeng, CHEN Yi, DENG Yan, FENG Ai, HUANG Juan, CHEN Lizhu, XIE Jingqi, NIE Xiaojing. A comparative study on the detection of anti-Nephrin antibodies in children's nephrotic syndrome by chemiluminescence method and cell-based assay [J]. Journal of Clinical Pediatrics, 2026, 44(8): 682-689. |
| [2] | ZHENG Fangyuan, WANG Miao, DING Mingming, LU Aidong, JIA Yueping, ZENG Huimin, ZHANG Leping. Next-generation sequencing identified gene variants and their prognostic impact in pediatric Philadelphia chromosome positive acute lymphoblastic leukemia [J]. Journal of Clinical Pediatrics, 2026, 44(8): 690-697. |
| [3] | ZHANG Xiao, FANG Hongjun, KUANG Xiaojun, WANG Lijuan, WU Zhao, JIANG Sha, LI Pei, WU Liwen. Analysis of the clinical and electrophysiological characteristics of atonic seizures in children [J]. Journal of Clinical Pediatrics, 2026, 44(8): 698-704. |
| [4] | WANG Mengqian, YANG Hui. Case series analysis of 13 intestinal Behcet’s syndrome in children [J]. Journal of Clinical Pediatrics, 2026, 44(8): 705-711. |
| [5] | WU Xirong, GAO Qi, GUO Siyuan, YIN Qingqin, QIN Qiang, YIN Ju, JIAO Anxia, CHEN Chenghao, WU Di, WANG Bei, DUAN Xiaomin, PENG Yun, XU Baoping, GAO Liwei. Clinical characteristics and prognosis of pulmonary mucormycosis in children with diabetes mellitus [J]. Journal of Clinical Pediatrics, 2026, 44(8): 712-720. |
| [6] | HAN Yanan, GE Lanlan, CUI Jieyuan. A case report of branchio-oto-renal syndrome caused by EYA1 gene variant with a 6-year follow-up [J]. Journal of Clinical Pediatrics, 2026, 44(8): 721-726. |
| [7] | SHI Jiayi, GAO Chunlin, JIA Lili, LU Yunyun, SUN Tao, ZHU Xiaodong, XIA Zhengkun, ZHANG Pei. Phenotypic characteristics and prognostic analysis of a pedigree with childhood isolated nephrotic syndrome caused by compound heterozygous mutations in the COQ2 gene [J]. Journal of Clinical Pediatrics, 2026, 44(8): 727-732. |
| [8] | Rachel Rosen, Osvaldo Borrelli, Christophe Faure, Katja Karrento, Usha Krishnan, Samuel Nurko, Nathalie Rommel, Alan Silverman, Michiel van Wijk, Marc Benninga (Author), Chinese Medical Association Parenteral and Enteral Nutrition Branch Pediatrics Group, The Subspecialty Group of Gastroenterology, The Society of Pediatric, Chinese Medical Association, Gastroenterology Group, Pediatrician Branch, Chinese Medical Doctor Association (Translator). Core interpretation and explanation of Rome Ⅴ diagnostic criteria: upper gastrointestinal disorders of gut-brain interaction in children and adolescents [J]. Journal of Clinical Pediatrics, 2026, 44(7): 595-608. |
| [9] | Carlo Di Lorenzo, Miguel Saps, Bruno P. Chumpitazi, Shaman Rajindrajith, Annamaria Staiano, Nikhil Thapar, Miranda van Tilburg, Carlos Velasco-Benítez, Arine Vlieger (Author), Chinese Medical Association Parenteral and Enteral Nutrition Branch Pediatrics Group, The Subspecialty Group of Gastroenterology, The Society of Pediatric, Chinese Medical Association, Gastroenterology Group, Pediatrician Branch, Chinese Medical Doctor Association (Translator). Core interpretation and explanation of Rome Ⅴ diagnostic criteria: lower and biliary disorders of gut-brain interaction in children and adolescents [J]. Journal of Clinical Pediatrics, 2026, 44(7): 609-621. |
| [10] | LI Xufeng, TANG Haoxun, LI Xingjun, ZHANG Lize, GAO Chenqing, ZHAO Shunying, LIU Jianhua. Clinical characteristics, chest CT imaging phenotypes, and their correlation with prognosis in 76 children with Chlamydia pneumoniae pneumonia [J]. Journal of Clinical Pediatrics, 2026, 44(7): 622-627. |
| [11] | WANG Zhen, SHAO Jingbo, ZHANG Na, XIA Min, ZHU Jiashi, DU Chengkan, LI Hong. Factors influencing long-term recurrence in pediatric acute lymphoblastic leukemia patients with low-risk disease at initial diagnosis: a five-year follow-up analysis of 254 cases from a single center [J]. Journal of Clinical Pediatrics, 2026, 44(7): 628-635. |
| [12] | GUO Xuemei, XUE Yao, WANG Yongren, RONG Liucheng, FANG Yongjun, LIN Rufeng. Clinical features and prognosis of childhood acute myeloid leukemia with CBFA2T3::GLIS2 fusion [J]. Journal of Clinical Pediatrics, 2026, 44(7): 636-643. |
| [13] | YANG Lijun, FU Dongxia, CUI Yan, YANG Junmei, ZHANG Liming. Clinical manifestation and genetic analysis of CHARGE syndrome caused by CHD7 gene variation [J]. Journal of Clinical Pediatrics, 2026, 44(7): 644-650. |
| [14] | HU Yan, YANG Fan, LIANG Aimin, MAO Meng. Identification and management of faltering growth in children: insights from the 13th International Conference on Nutrition and Growth [J]. Journal of Clinical Pediatrics, 2026, 44(6): 485-488. |
| [15] | LIU Ziyao, WANG Congying, WANG Hongmao, ZHANG Mingming, XU Yingjie, LAI Jianming, NIU Wenquan, LI Xiaohui. Early differentiation of Kawasaki disease with joint symptoms and systemic juvenile idiopathic arthritis with Kawasaki disease-like symptoms: a single-center retrospective study [J]. Journal of Clinical Pediatrics, 2026, 44(6): 489-498. |
|
||