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儿童慢性肾脏病的管理概述

Authors
Tarak Srivastava, MD
Bradley A Warady, MD
Section Editor
Tej K Mattoo, MD, DCH, FRCP
Deputy Editor
Melanie S Kim, MD
Translators
马青山, 主任医师，教授

引言

慢性肾脏病(chronic kidney disease, CKD)是指一种不可逆性肾脏损害和/或肾功能下降的状态，其可能是进行性的。CKD是儿科肾脏学界目前认可的术语，取代了慢性肾衰竭(chronic renal failure, CRF)和慢性肾功能不全(chronic renal insufficiency, CRI)这两个临床术语，这两个术语描述了性质上从重度到轻度的不同程度的肾功能障碍。CKD更加明确地将肾功能障碍定义为一种连续(而非不连续)的肾功能改变，本专题将通篇使用CKD这一术语。

儿童CKD管理概述将总结在此。儿童CKD的病因学、流行病学、自然病程、表现和评估将单独讨论。(参见“儿童慢性肾脏病的流行病学、病因及病程”和“儿童慢性肾脏病的临床表现和评估”)

定义

改善全球肾脏病预后组织(Kidney Disease: Improving Global Outcomes, KDIGO)2012年CKD评估及管理临床实践指南(Clinical Practice Guideline, CPG)修订了美国肾脏病预后质量倡议(Kidney Disease Outcomes Quality Initiative, KDOQI)CKD临床实践指南制定的2002年儿科CKD分类[1,2]。KDIGO分类包括病因、基于肾小球滤过率(glomerular filtration rate, GFR)的肾功能、是否存在白蛋白尿排泄及其排泄率。 (参见“儿童慢性肾脏病的流行病学、病因及病程”，关于‘定义及分类’一节)

根据KDIGO标准，满足以下临床标准之一即可诊断为儿科CKD：

●GFR小于60mL/(min·1.73m2)持续3个月以上并对健康有影响，无论是否存在其他CKD指标。

                                        

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Literature review current through: 2017-06 . | This topic last updated: 2016-05-25.
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