肾小管酸中毒儿童的肾钙化:儿科医生须知

Mohammed Al-Beltagi, N. Saeed, A. Bediwy, Reem Elbeltagi, Samir Hasan, Mohamed Basiony Hamza
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摘要

肾小管酸中毒(RTA)可导致儿童肾脏钙化,引起各种并发症,损害肾功能。这篇综述为儿科医生提供了RTA与肾钙化之间关系的全面理解,强调了临床管理的重要方面。本文通过对相关研究的分析,探讨RTA患儿肾脏钙化的患病率、危险因素、潜在机制及临床意义。结果显示远端RTA(1型)特别与肾钙化症相关,肾钙化的风险更高。然而,现有文献存在局限性,包括研究数量少、方法异质性和潜在的发表偏倚。纵向数据和对照组也缺乏,这限制了我们对RTA和肾钙化儿童的长期结果和最佳管理策略的理解。儿科医生在RTA的早期诊断和管理中起着至关重要的作用,以减轻肾钙化和相关并发症的风险。此外,碱性疗法仍然是RTA治疗的基石,旨在纠正酸碱失衡,减少肾结石的形成。因此,早期诊断和适当的治疗干预对于预防和管理肾钙化至关重要,以保护肾功能并改善受影响儿童的长期预后。进一步的研究需要更大的样本量和严格的方法来优化儿科人群RTA背景下肾钙化的临床方法。
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Renal calcification in children with renal tubular acidosis: What a paediatrician ‎should ‎know‎
Renal tubular acidosis (RTA) can lead to renal calcification in children, which can cause various complications and impair renal function. This review provides pediatricians with a comprehensive understanding of the relationship between RTA and renal calcification, highlighting essential aspects for clinical management. The article analyzed relevant studies to explore the prevalence, risk factors, underlying mechanisms, and clinical implications of renal calcification in children with RTA. Results show that distal RTA (type 1) is particularly associated with nephrocalcinosis, which presents a higher risk of renal calcification. However, there are limitations to the existing literature, including a small number of studies, heterogeneity in methodologies, and potential publication bias. Longitudinal data and control groups are also lacking, which limits our understanding of long-term outcomes and optimal management strategies for children with RTA and renal calcification. Pediatricians play a crucial role in the early diagnosis and management of RTA to mitigate the risk of renal calcification and associated complications. In addition, alkaline therapy remains a cornerstone in the treatment of RTA, aimed at correcting the acid-base imbalance and reducing the formation of kidney stones. Therefore, early diagnosis and appropriate therapeutic interventions are paramount in preventing and managing renal calcification to preserve renal function and improve long-term outcomes for affected children. Further research with larger sample sizes and rigorous methodologies is needed to optimize the clinical approach to renal calcification in the context of RTA in the pediatric population.
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