Pediatric ARF epidemiology at a tertiary care center from 1999 to 2001
Pediatric ARF epidemiology at a tertiary care center from 1999 to 2001
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DOI：
10.1053/j.ajkd.2004.09.028
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发表时间：
2005-01-01
影响因子：
13.2
通讯作者：
Goldstein, SL
中科院分区：
文献类型：
--
作者：
Hui-Stickle, S;Brewer, ED;Goldstein, SL
背景：先前儿童急性肾功能衰竭(ARF)患者的流行病学数据早于当前的重症监护病房(ICU)技术和实践，并没有反映骨髓、肝脏和心脏移植以及先天性心脏病手术的新疾病治疗方法。方法我们对1998年1月至2001年6月德克萨斯儿童医院(德克萨斯州休斯敦)出院的248名儿童的254例ARF进行了回顾性分析，以更新当前儿童ARF的流行病学特征。结果：ARF最常见的原因是肾缺血(21%)、肾毒性药物(16%)和脓毒症(11%)。原发肾脏疾病仅17例(7%)，溶血性尿毒症综合征仅3例。整个队列的ARF总存活率为254名患者中的176名(70%)，而需要ICU入院的185名患者中的110名(60%)和接受肾脏替代治疗的77名患者中的43名(56%)存活。结论：目前儿童ARF的流行病学特征已从原发肾脏疾病转变为继发性肾脏损害，继发于其他全身疾病。来自该队列的纵向数据正在进行中，以确定儿科ARF的长期后遗症。(C)2004年，由国家肾脏基金会公司提供。
Background: Previous epidemiological data for pediatric patients with acute renal failure (ARF) predate current intensive care unit (ICU) technology and practice, and do not reflect newer disease therapies for bone marrow, hepatic, and cardiac transplantation and congenital heart disease surgery. Methods We conducted a retrospective review of 254 ARF episodes in 248 children discharged from a tertiary referral center, Texas Children's Hospital (Houston, TX), between January 1998 and June 2001 to update current pediatric ARF epidemiological characteristics. Results: The most common causes of ARF were renal ischemia (21 %), nephrotoxic medications (16 %), and sepsis (11 %). Primary renal diseases accounted for only 17 cases (7 %), and hemolytic uremic syndrome accounted for only 3 cases. Overall ARF survival for the entire cohort was 176 of 254 patients (70 %), whereas 110 of 185 patients (60 %) requiring ICU admission and 43 of 77 patients (56 %) receiving renal replacement therapy survived. Conclusion: These current pediatric ARF data show that pediatric ARF epidemiological characteristics have changed from primary renal disease to renal involvement secondary to other systemic illness. Longitudinal data from this cohort are underway to determine the long-term sequelae of pediatric ARF. (C) 2004 by the National Kidney Foundation, Inc.