肾功能异常指多种原因,包括肾脏疾病或非肾脏疾病引起的血肌酐和尿素氮升高,伴或不伴水肿、电解质紊乱、高血压等多系统、脏器累及症状。儿科临床上很大一部分患者以肾功能异常为首发表现。笔者就儿童肾功能异常的诊断思路进行综述,提出儿童肾功能异常的诊断应该遵循病程和肾功能分期、定位、定因、并发症评估的程序,其中特别建议无论急性或慢性肾功能异常,肾功能分级均采用目前慢性肾脏病的国际分级标准,病因方面儿童肾功能异常仍以遗传性疾病最为常见。先天性肾脏和尿路畸形只是一种形态学诊断,其病因也可能仍以遗传因素为主。

Renal dysfunction refers to a variety of situations, including kidney diseases and other diseases, which cause the increase of creatinine and urea nitrogen, accompanied with edema, electrolyte disorder, hypertension and other multiple system related symptoms in some cases. A large proportion of patients were characterized by renal dysfunction as the primary symptom in children. The author summarized the diagnosis approach on childhood renal dysfunction, suggested that the stage on renal function should be based on the same classification standard as in chronic renal disease. Hereditary disease is the most common cause of renal dysfunction in children. Congenital anomalies of the kidney and urinary tract, which might be mainly results from developmental abnormalities, represent a broad spectrum of disorders.