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Chronische Niereninsuffizienz im Kindesalter

Chronic kidney disease in childhood

  • Leitthema
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Monatsschrift Kinderheilkunde Aims and scope Submit manuscript

Zusammenfassung

Definition

Die chronische Niereninsuffizienz (CNI) im Kindesalter ist eine seltene, in der Regel prognostisch ungünstige Erkrankung, die ab einer kritisch unterschrittenen Nephronmasse irreversibel ist und zur terminalen Niereninsuffizienz mit Dialysepflichtigkeit führt.

Ätiologie

Ätiologisch liegen der CNI am häufigsten renale Hypo- und Dysplasien, mit und ohne vesikoureteralen Reflux, hereditäre Nierenerkrankungen und erworbene Glomerulopathien zugrunde.

Therapie/Prävention

Um den irreversiblen Status der Niereninsuffizienz zu verhindern oder zumindest die Progression der CNI zu verzögern, wurden in den letzten Jahren verschiedene Progressionsfaktoren hinsichtlich ihrer Relevanz untersucht und Therapierichtlinien modifiziert. Unabhängig von der zugrundeliegenden Erkrankung ist es für den Erhalt der Nierenfunktion entscheidend, den Blutdruck exakt einzustellen und die Proteinurie zu reduzieren.

Abstract

Definition

Chronic kidney disease (CKD) in childhood is a rare but devastating condition that is irreversible and results in end-stage renal disease (ESRD) and need for renal replacement therapy once a critical nephron mass has been lost.

Ethiology

Congenital renal hypodysplasia with or without urinary tract abnormalities is the main cause of CKD in childhood, followed by hereditary nephropathies and acquired glomerulopathies.

Therapy/prevention

Several progression factors have been identified in recent years and potential therapeutic strategies to prevent disease progression have been modified. Irrespective of the underlying kidney disease, strict blood pressure control and reduction of urinary protein excretion are mandatory in children with CKD.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. B. Lange-Sperandio und J. Dötsch geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Lindwurmstraße 4, 80337, München, Deutschland

    B. Lange-Sperandio

  2. Klinik und Poliklinik für Kinder- und Jugendmedizin, Köln, Deutschland

    J. Dötsch

Authors
  1. B. Lange-Sperandio
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  2. J. Dötsch
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Correspondence to B. Lange-Sperandio.

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Lange-Sperandio, B., Dötsch, J. Chronische Niereninsuffizienz im Kindesalter. Monatsschr Kinderheilkd 161, 988–994 (2013). https://doi.org/10.1007/s00112-013-2946-z

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  • DOI: https://doi.org/10.1007/s00112-013-2946-z

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