临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (9): 713-.doi: 10.3969/j.issn.1000-3606.2017.09.019

• 文献综述 • 上一篇    下一篇

儿童肾瘢痕形成的危险因素

孙玉综述, 沈茜审校   

  1. 复旦大学附属儿科医院肾脏科 上海市肾脏发育和儿童肾脏病研究中心(上海 201102)
  • 收稿日期:2017-09-15 出版日期:2017-09-15 发布日期:2017-09-15

Risk factors for renal scarring in children 

Reviewer: SUN Yu, Reviser: SHEN Qian   

  1. Department of Nephrology, Children's Hospital of Fudan University, Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai 201102, China
  • Received:2017-09-15 Online:2017-09-15 Published:2017-09-15

摘要: 肾瘢痕可导致高血压、蛋白尿、慢性肾脏病、甚至终末期肾病的可能。研究儿童肾瘢痕形成的危险因素,有利 于早发现、早诊断、早预防、早治疗。高级别的膀胱输尿管反流,反复的泌尿道感染,以及延误治疗都是肾瘢痕形成的危险 因素。但是仍有一些因素,如性别和年龄,先天性因素与肾瘢痕的关系目前仍存在争议。近年研究发现,尿液无创指标,如 尿中性粒细胞明胶酶相关脂质运载蛋白、尿内皮素-1及风险预测模型均可预测肾瘢痕的形成,而预防应用抗生素虽可减 少泌尿道感染的发生,但并不能降低肾瘢痕形成的风险。文章综述了儿童肾瘢痕形成的可能危险因素和预测指标,为临床 对肾瘢痕的早期发现、及时干预和有效预防提供依据,以期减少肾瘢痕的形成和进展。

Abstract:  Renal scarring can cause hypertension, proteinuria, chronic kidney disease, and even end stage renal disease. To understand the risk factors of renal scarring in children is helpful for its early detection, diagnosis, prevention, and treatment. High grade vesicoureteric reflux, recurrent urinary tract infection, and delayed treatment are risk factors for kidney scarring. However, there are still some controversies about the relationship between renal scarring and the some factors such as gender, age, and congenital factors. Recent studies have found that noninvasive urine indicators such as urine neutrophil gelatinase associated lipid delivery protein, urinary endothelin-1, and risk prediction models can predict the formation of renal scar. However, prophylactic use of antibiotics can reduce occurance of urinary tract infections, but do not reduce the risk of renal scarring. This article reviews the possible risk factors and predictors of renal scarring in children, providing a basis for early detection, timely intervention, and effective prevention of it in clinic, so as to reduce the formation and progression of renal scarring.