NEJM:儿童期肾病大幅增加成年后终末期肾脏疾病风险

2018-02-01 zhangfan MedSci原创

研究认为,对于儿童期肾病患者,即便其青春期肾功能正常,其成年后终末期肾脏疾病风险大幅增加

儿童期肾病发展为慢性肾病的长期风险研究尚不充分。近日研究人员考察了青春期肾功能正常的儿童肾病患者,成年后的终末期肾脏疾病(ESRD)风险。

1967-1997年间,1521501名以色列儿童参与研究。儿童肾脏疾病包括先天性肾脏和泌尿道异常、肾盂肾炎和肾小球疾病。所有参与者青春期肾功能正常且无高血压。采用Cox比例风险模型估计与儿童肾病史相关的ESRD风险。

随访30年后,2490人发生ESRD。任何儿童肾病史增加ESRD风险(HR,4.19,CI,3.52-4.99)。不同儿童肾脏疾病(先天性肾,尿路畸形、肾盂肾炎及肾小球疾病)的成年ESRD风险相似(多变量调整HR分别为5.19 [95% CI,3.41-7.90], 4.03 [95% CI,3.16-5.14]和3.85 [95% CI,2.77-5.36])。儿童肾病史与ESRD年龄提前相关 (ESRD年龄早于40岁的风险,10.40 [95% CI,7.96-13.59])。

研究认为,对于儿童期肾病患者,即便其青春期肾功能正常,其成年后终末期肾脏疾病风险大幅增加。

原始出处:

Ronit Calderon-Margalit et al. History of Childhood Kidney Disease and Risk of Adult End-Stage Renal Disease. N Engl J Med. February 1 2018.

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