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Pädiatrisch nephrologische Erkrankungen nach dem Transfer

Pediatric renal diseases after transfertransition to adult care

  • Leitthema
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Der Nephrologe Aims and scope

Zusammenfassung

Durch das verbesserte Langzeitüberleben von Kindern mit chronischen Nierenerkrankungen wird der internistische Nephrologe zunehmend konfrontiert mit jungen Erwachsenen, die teils an seltenen genetischen oder metabolischen Erkrankungen der Nieren und ableitenden Harnwege ledien. Rezidivierende Verläufe, extrarenale Manifestationen und Langzeitkomplikationen chronischer Nierenerkrankungen, wie Kleinwuchs, gestörte psychosoziale Adaptation und erhöhtes kardiovaskuläres Mortalitätsrisiko, machen die internistische Betreuung dieser jungen Menschen zu einer Herausforderung. Die Kenntnis klinischer Klassifikationen, Verläufe und Behandlungsprinzipien sind unabdingbar. Neben den angeborenen Fehlbildungen von Nieren und ableitenden Harnwegen werden das nephrotische Syndrom, das hämolytisch-urämische Syndrom, die nephropathische Zystinose und, als Vertreter der Ziliopathien, die Nephronophthise dargestellt. Rotationen in der Ausbildung zum Kindernephrologen /internistischen Nephrologen können helfen, den Wissensaustausch zu fördern und organisatorische Hemmnisse bei der Transition abzubauen.

Abstract

Due to improved long-term survival of children with chronic kidney diseases (CKD), the adult nephrologist is increasingly facing young adults with rare genetic or metabolic chronic renal illnesses. Disease recurrence, extrarenal manifestations, and long-term complications of CKD, such as growth retardation, disturbed psychosocial adaption, and increased risk of cardiovascular mortality, are challenging for further medical care. Knowledge about clinical classifications, courses, and therapeutic principles of these diseases are, therefore, mandatory. This article depicts not only congenital malformations of the kidneys and the urinary tract, but also describes nephrotic syndrome, hemolytic–uremic syndrome, nephropathic cystinosis, and exemplary for ciliopathies nephronophthisis. Rotations during the training of both pediatric and adult nephrologists have the potential to increase clinical knowledge and reduce organizational barriers of transition.

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  1. Pädiatrische Nephrologie, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Universitätsklinikum München, Lindwurmstr. 4, 80337, München, Deutschland

    L.T. Weber

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Weber, L. Pädiatrisch nephrologische Erkrankungen nach dem Transfer. Nephrologe 6, 9–21 (2011). https://doi.org/10.1007/s11560-010-0475-5

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