ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2025, Vol. 34 ›› Issue (1): 21-26.DOI: 10.3969/j.issn.1006-298X.2025.01.004

• 论著 • 上一篇    下一篇

单中心腹膜透析儿童的临床特点与转归分析

  

  • 出版日期:2025-02-28 发布日期:2025-03-15

Clinical characteristics and outcome of children with peritoneal dialysis in a single center

  • Online:2025-02-28 Published:2025-03-15

摘要: 目的:了解行腹膜透析的终末期肾病(ESKD)患儿的临床特征、并发症及转归预后。  方法:回顾性分析 2016 年 6 月至 2024 年 6 月于河南省儿童医院行腹膜透析(PD)治疗并于国际儿童透析协作网中文版(IPDN-China)登记信息的 ESKD 患儿资料。      结果:74 例患儿中男性 50 例(67.57%),开始 PD 年龄 9 月龄至 16岁9 月,中位年龄 9 岁 4 月;开始 PD 时估算的肾小球滤过率(eGFR)10.6± 4.3 mL/(min·1.73m2 )。  病因:肾小球疾病 39 例(52.70%),先天遗传代谢性疾病 35 例(47.30%),42 例患儿进行基因检测,阳性 30 例(71.43%)。 截至2024 年 6 月平均 PD 时间为 12.12 月;97.30%为自动化腹膜透析(APD),2.70%为持续性非卧床腹膜透析;平均腹膜炎发生率为 1 次/ 26.9 治疗月。  尿素清除指数(Kt/V)3.1 ± 0.7。  常见并发症包括高磷血症(77.03%)、贫血(67.57%),左心室肥厚(43.24%)、高血压(37.84%)、继发性甲状旁腺功能亢进(36.49%)。 随访终点时,58 例(78.38%)已终止 PD,终止原因包括肾移植 56 例(96.55%)、失访 1 例(1.72%)、死亡 1 例(1.72%),现维持 PD 患儿 16 例。 结论:APD 已成为 ESKD 患儿重要的替代治疗方式,可有效地延续生命、为肾移植创造条件。

关键词: 儿童, 终末期肾病, 肾小球疾病, 高血磷, 自动化腹膜透析,  , 国际儿童透析协作网中文版

Abstract: Objective:To investigate the clinical characteristics, complications and prognosis of children with end- stage kidney disease (ESKD)undergoing peritoneal dialysis (PD).    Methodology:The data of ESKD children who received PD and were followed in the  International  Pediatric  Dialysis  Network, IPDN-China  from June 2016 to  June 2024 in Henan Children's Hospital were  retrospectively  analyzed.    Results:Among  the 74 children, there  were 50 males  and 24 females, with an age range of 9 months to 16 years and 9 months.  The median age at the start of PD was 9 years and 4 months.The estimated glomerular filtration rate (eGFR)at the time of initiation of PD was 10.6±4.3 mL/(min·1.73m2 ). The causes of ESKD included glomerular disease in 39 cases (52.70%) and congenital genetic metabolic diseases in 35 cases (47.30%). Genetic testing was  performed  in 42  children, with  positive  results  in 30  cases  (71.43%).  As  of  June  2024,  the  average duration of PD was  12.12  months.  97.30%  of  the  children  underwent  automated  peritoneal  dialysis  (APD),  and  2.70% underwent continuous ambulatory peritoneal dialysis (CAPD). The average peritonitis rate was 1 episode per 26.9 treatment months. The urea  clearance  index  (Kt/V) was  3.1  ±  0.7  per  week.  Common  complications  included  hyperphosphatemia

(77.03%),  anemia   (67.57%),  left   ventricular   hypertrophy   (43.24%),  hypertension   (37.84%),  and   secondary hyperparathyroidism (36.49%).  At  the  end  of  follow-up,  58  children  (78.38%) had  discontinued  PD.  The  reasons  for discontinuation included kidney transplantation in 56 cases (96.55%), loss to follow-up in 1 case (1.72%), and death in 1 case (1.72%).  Currently,  16  children  are  still  undergoing  PD.     Conclusion: APD  has  become  an  important  alternative treatment for ESKD children, effectively prolonging life and creating conditions for kidney transplantation.


Key words: children, end-stage , kidney , disease, glomerular , disease, hyperphosphatemia, automated , peritoneal dialysis, International Pediatric Dialysis