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Glomerulopathien in der pädiatrischen Intensivmedizin

  • Leitthema: Glomerulopathien
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Zusammenfassung

Ein akutes dialysepflichtiges Nierenversagen im Kindesalter wird in etwa 6% der Fälle durch Glomerulopathien verursacht. Häufig ist eine intensivmedizinische Behandlung erforderlich, insbesondere wenn sekundäre Organkomplikationen aufgetreten sind. Diese zeigen oft eine vorwiegend neurologische Symptomatik und erfordern eine dringliche Diagnostik und Therapie. Neben dem relativ häufigen hämolytisch-urämischen Syndrom kann eine Vielfalt von Glomerulopathien zum akuten Nierenversagen führen. Bei einigen dieser Erkrankungen kann bei frühzeitiger Diagnosestellung durch aggressive Therapie zumindest die Langzeitprognose verbessert werden. Beim Krankheitsbild der rapid progressiven Glomerulonephritis sind dazu in letzter Zeit bei erwachsenen Patienten therapeutische Fortschritte erzielt worden, die auch für die Pädiatrie relevant sein könnten. Der Einsatz spezieller Blutreinigungsverfahren wie Plasmapherese oder Immunadsorption bei Kindern wird in dieser Arbeit ebenfalls diskutiert.

Abstract

Acute renal failure is caused by glomerulopathies in about 6% of paediatric cases. Patients often have to be admitted to the intensive care unit, especially when there is secondary organ involvement. The symptoms that develop are mainly neurological, demanding rapid diagnosis and treatment. There are various glomerulopathies besides haemolytic-uraemic syndrome, which is encountered relatively often, that can lead to acute renal failure. In some of these, the long-term prognosis at least can be significantly improved by rapid diagnosis and aggressive treatment. In the case of rapidly progressive glomerulonephritis there have been recent advances in treatment in adult medicine, which may also prove applicable in pediatric patients. The use of more specific blood purification procedures, such as plasmapheresis or immunoadsorption, in children is also discussed.

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Authors and Affiliations

  1. Pädiatrische Intensivmedizin, Kinderklinik und Kinderpoliklinik, Dr. von Haunersches Kinderspital, Universität München

    K. Reiter

  2. Pädiatrische Nephrologie, Kinderklinik und Kinderpoliklinik, Dr. von Haunersches Kinderspital, Universität München

    M. R. Benz & R. Eife

  3. Pädiatrische Intensivmedizin, Kinderklinik und Kinderpoliklinik, Dr. von Haunersches Kinderspital, Universität München, Lindwurmstraße 4, 80337, München, Deutschland

    K. Reiter

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  1. K. Reiter
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  3. R. Eife
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Correspondence to K. Reiter.

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Reiter, K., Benz, M.R. & Eife, R. Glomerulopathien in der pädiatrischen Intensivmedizin . Monatsschr Kinderheilkd 152, 273–279 (2004). https://doi.org/10.1007/s00112-004-0905-4

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