Editorial Pediatric Nephrology: an Update

A. Barakat
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引用次数: 156

Abstract

Pediatric nephrology is rapidly evolving. Over the last few decades we have witnessed a rapid change in nosology, etiology, pathogenesis and treatment of renal disease. We have seen advances in renal and urinary tract imaging as well as more precise use of novel urinary biomarkers to define the type and degree of renal injury, both acute and chronic. We now have better understanding of factors contributing to normal and abnormal renal development, particularly the progenitors of renal development and regeneration, delivery of progenitor cell therapeutics, and the role of epigenetics [1]. Multi center pan-national and international clinical studies have helped to put together clinical guidelines to diagnose and manage renal disease. In this issue, we will discuss few, but important recent clinical developments in pediatric nephrology.
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儿科肾脏病学:最新进展
我很荣幸能够担任本期《开放泌尿学与肾脏病学杂志》儿科肾病特刊的客座编辑。我也很感谢杰出的作者小组,感谢他们的贡献,感谢他们介绍了该专业各个方面的最新临床进展。儿科肾脏病学正在迅速发展。在过去的几十年里,我们目睹了肾脏疾病在分类学、病因学、发病机制和治疗方面的快速变化。我们已经看到肾脏和尿路成像的进步,以及更精确地使用新的尿液生物标志物来定义肾损伤的类型和程度,无论是急性还是慢性。我们现在对导致肾脏正常和异常发育的因素有了更好的了解,特别是肾脏发育和再生的祖细胞,祖细胞治疗的传递,以及表观遗传学的作用。多中心、泛国家和国际临床研究有助于制定诊断和管理肾脏疾病的临床指南。在这一期中,我们将讨论儿科肾脏病学中一些重要的近期临床进展。虽然进行肾脏超声和排尿膀胱输尿管造影(VCUG)曾经是一种常规,但美国儿科学会(AAP)和国家卫生与临床卓越研究所(NICE)现在建议显著减少2-3岁以下发热性尿路感染(UTI)患儿的影像学检查。AAP和NICE也一致认为,这些儿童即使有严重膀胱输尿管反流(VUR),也不应常规使用预防性抗生素治疗。目前,美国儿科学会建议患有发热性尿路感染的婴儿(2-24个月)进行肾脏和膀胱超声检查作为常规筛查,对于复发性尿路感染或超声显示解剖异常的患者保留VCUG检查。2014年,也就是在这一建议的三年后,膀胱输尿管反流儿童随机干预(RIVUR)研究的结果发表于bbb。根据这项研究,抗生素预防确实可以预防幼儿VUR尿路感染复发,但代价是抗生素耐药性增加,并且在预防潜在肾损害方面的益处尚不清楚。遗传因素可能与尿路感染的风险有关,未来可能会有遗传标记来帮助更精确地选择有疤痕风险的儿童,从而帮助确定需要抗生素治疗的患者。尽管进行了广泛的研究,关于如何筛查和治疗患者的争论……
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CiteScore
0.30
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0.00%
发文量
7
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