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Paediatric Nephrology最新文献

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The neonate 新生儿
Pub Date : 2019-02-01 DOI: 10.1093/med/9780198784272.003.0002
L. Rees, N. Webb, D. Bockenhauer, M. Punaro
Immaturity of the neonatal kidney predisposes to renal injury. Causes, treatment, and outcome are different to older children.
新生儿肾脏发育不成熟易致肾损伤。病因、治疗和结果与年龄较大的儿童不同。
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引用次数: 0
Hypertension 高血压
Pub Date : 2019-02-01 DOI: 10.1093/med/9780198784272.003.0016
L. Rees, N. Webb, D. Bockenhauer, M. Punaro
In children, hypertension by definition affects <5% of the paediatric population. In contrast to adults, where hypertension is typically idiopathic, a primary cause is often identified, especially in young children. This chapter reviews the definition and diagnosis of hypertension and the work-up to identify a potentially underlying cause. The latter is critical to instigate appropriate treatment.
在儿童中,根据定义,高血压影响不到5%的儿科人口。成人的高血压通常是特发性的,与之相反,通常可以确定主要原因,特别是在幼儿中。本章回顾了高血压的定义和诊断,以及确定潜在病因的检查。后者是促成适当治疗的关键。
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引用次数: 0
Transplantation 移植
Pub Date : 2019-02-01 DOI: 10.1093/med/9780198784272.003.0021
L. Rees, N. Webb, D. Bockenhauer, M. Punaro
Kidney transplantation offers children with chronic kidney disease stage 5 the best chance of long-term survival and is associated with lower morbidity than long-term dialysis. However, transplantation surgery and the necessary long-term immunosuppressive therapy expose the child to an increased risk of a number of different complications, including infection, metabolic abnormalities, and malignancy. In the era of modern immunosuppressive therapy, acute rejection rates are low; however, there remain significant challenges regarding the management of recurrent disease and chronic antibody-mediated rejection.
肾移植为慢性肾脏疾病5期儿童提供了最佳的长期生存机会,并且与长期透析相比发病率更低。然而,移植手术和必要的长期免疫抑制治疗使儿童暴露于许多不同并发症的风险增加,包括感染、代谢异常和恶性肿瘤。在现代免疫抑制治疗时代,急性排斥率很低;然而,在复发性疾病和慢性抗体介导的排斥反应的管理方面仍然存在重大挑战。
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引用次数: 0
Psychosocial issues 社会心理问题
Pub Date : 2019-02-01 DOI: 10.1093/med/9780198784272.003.0023
L. Rees, N. Webb, D. Bockenhauer, M. Punaro
In common with many chronic disease populations, children with chronic kidney disease experience high rates of psychosocial problems. Non-adherence with prescribed therapy is a major issue, particularly during the teenage years, and is associated with reduced transplant survival and other adverse outcomes. Many children have multiple co-morbidities and complex ethical issues may arise relating to the commencement of invasive life-prolonging interventions, including dialysis and transplantation. Where a decision is made to discontinue life-sustaining therapy, it is essential that appropriate palliative care is provided.
与许多慢性病人群一样,患有慢性肾病的儿童出现社会心理问题的比率很高。不遵守处方治疗是一个主要问题,特别是在青少年时期,并与移植存活率降低和其他不良后果有关。许多儿童患有多种合并症,并可能出现与侵入性延长生命干预措施(包括透析和移植)有关的复杂伦理问题。当决定停止维持生命的治疗时,提供适当的姑息治疗至关重要。
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引用次数: 0
Enuresis 尿床
Pub Date : 2019-02-01 DOI: 10.1093/med/9780198784272.003.0005
L. Rees, N. Webb, D. Bockenhauer, M. Punaro
Enuresis is common and it is important to know whether the cause is benign or pathological.
遗尿是常见的,重要的是要知道是良性的还是病理性的原因。
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引用次数: 0
Electrolyte and acid–base disorders 电解质和酸碱紊乱
Pub Date : 2019-02-01 DOI: 10.1093/MED/9780198784272.003.0006
L. Rees, N. Webb, D. Bockenhauer, M. Punaro
The kidneys are tasked with maintaining electrolyte and acid–base homeostasis. This means that the kidneys adjust urinary excretion, so that the concentrations of the various electrolytes in the plasma are maintained in the normal range. In this chapter, the various electrolyte and acid–base disorders are discussed with an emphasis on the underlying physiological principles. Recognition of these principles is critical, as correct identification of the underlying problem is key to adequate treatment.
肾脏的任务是维持电解质和酸碱平衡。这意味着肾脏调节尿排泄,使血浆中各种电解质的浓度维持在正常范围内。在本章中,讨论了各种电解质和酸碱紊乱,重点是潜在的生理原理。认识到这些原则是至关重要的,因为正确识别潜在问题是适当治疗的关键。
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引用次数: 0
Glomerular disease 肾小球疾病
Pub Date : 2019-02-01 DOI: 10.1093/med/9780199601370.003.0084
L. Rees, N. Webb, D. Bockenhauer, M. Punaro
Understanding of the pathogenesis of nephrotic syndrome is rapidly increasing and new treatments are evolving. However, these diseases remain difficult to manage, with little evidence to help decide on optimum treatment strategies.
对肾病综合征发病机制的了解正在迅速增加,新的治疗方法也在不断发展。然而,这些疾病仍然难以控制,几乎没有证据可以帮助决定最佳治疗策略。
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引用次数: 0
Renal dysplasia and other manifestations in syndromic diseases 肾发育不良及其他综合征性疾病的表现
Pub Date : 2019-02-01 DOI: 10.1093/MED/9780198784272.003.0014
L. Rees, N. Webb, D. Bockenhauer, M. Punaro
Renal abnormalities can occur alone or as part of a syndrome. Many children with chromosomal defects have renal abnormalities.
肾脏异常可单独发生或作为综合征的一部分。许多有染色体缺陷的儿童有肾脏异常。
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引用次数: 0
Tubular disorders 管疾病
Pub Date : 2019-02-01 DOI: 10.1093/med/9780198784272.003.0007
L. Rees, N. Webb, D. Bockenhauer, M. Punaro
Tubular function is critical for the maintenance of electrolyte and acid–base balance. Consequently, acid–base disorders typically manifest with alterations in plasma electrolyte concentrations and/or pH. Tubular handling of the various electrolytes is often linked on a molecular level. For example, secretion of potassium and protons in the collecting duct is dependent on sodium reabsorption. Consequently, tubular disorders typically present with characteristic patterns of electrolyte and acid–base abnormalities, which can serve as biochemical ‘fingerprints’ for the accurate diagnosis of the underlying disorder. Recognition of these ‘fingerprints’ is critical as correct identification of the underlying disorder is key for appropriate treatment.
管状功能对维持电解质和酸碱平衡至关重要。因此,酸碱失调通常表现为血浆电解质浓度和/或ph的改变。各种电解质的管状处理通常在分子水平上联系在一起。例如,钾和质子在收集管中的分泌依赖于钠的再吸收。因此,小管性疾病通常表现为电解质和酸碱异常的特征性模式,这可以作为准确诊断潜在疾病的生化“指纹”。识别这些“指纹”至关重要,因为正确识别潜在疾病是适当治疗的关键。
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引用次数: 6
Acute kidney injury 急性肾损伤
Pub Date : 2019-02-01 DOI: 10.1093/med/9780198784272.003.0017
L. Rees, N. Webb, D. Bockenhauer, M. Punaro
The causes of acute kidney injury, the assessment of the patient, and management of the different causes are discussed in this chapter.
本章讨论了急性肾损伤的原因、患者的评估和不同原因的处理。
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引用次数: 0
期刊
Paediatric Nephrology
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