中国当代儿科杂志
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CN 43-1301/R
 
中国当代儿科杂志  2024, Vol. 26 Issue (9): 921-925    DOI:10.7499/j.issn.1008-8830.2405033
论著·临床研究 最新目录| 下期目录| 过刊浏览| 高级检索 |
儿童原发性肾病综合征并发急性肾损伤的早期识别
高洁, 陈朝英, 涂娟, 耿海云, 李华荣, 孙金山, 王楠楠, 黄永莉
首都儿科研究所附属儿童医院肾脏内科,北京 100020
Early identification of acute kidney injury in children with primary nephrotic syndrome
GAO Jie, CHEN Chao-Ying, TU Juan, GENG Hai-Yun, LI Hua-Rong, SUN Jin-Shan, WANG Nan-Nan, HUANG Yong-Li
Department of Kidney Internal Medicine, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
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摘要 目的 探讨儿童原发性肾病综合征(primary nephrotic syndrome, PNS)并发急性肾损伤(acute kidney injury, AKI)的发病率、相关危险因素,以及中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin, NGAL)、肾脏损伤因子1(kidney injury molecule-1, KIM-1)在PNS儿童并发AKI早期识别中的作用。 方法 前瞻性收集2021年1月—2022年10月于首都儿科研究所附属儿童医院住院治疗的PNS患儿的临床资料,根据是否并发AKI分为AKI组(47例)及非AKI组(169例)。采用多因素logistic回归分析探讨PNS并发AKI的危险因素,并比较各组间患儿尿KIM-1、NGAL水平与AKI分期的相关性。 结果 PNS患儿并发AKI的发病率为21.8%。多因素logistic回归分析显示,激素耐药型肾病综合征、消化道感染、大量蛋白尿是PNS患儿并发AKI的危险因素(P<0.05)。AKI患儿尿KIM-1、NGAL水平高于非AKI组(P<0.05),且AKI 2期亚组、AKI 3期亚组尿NGAL、KIM-1水平高于AKI 1期亚组(P<0.017)。 结论 KIM-1和NGAL可作为早期诊断PNS患儿合并AKI的生物标志物。确定PNS患儿并发AKI的重点监测人群,加强相关危险因素的监测具有重要意义。
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高洁
陈朝英
涂娟
耿海云
李华荣
孙金山
王楠楠
黄永莉
关键词 原发性肾病综合征急性肾损伤中性粒细胞明胶酶相关脂质运载蛋白肾脏损伤因子1儿童    
Abstract:Objective To investigate the incidence and risk factors for acute kidney injury (AKI) in children with primary nephrotic syndrome (PNS), as well as the role of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in the early identification of AKI in these children. Methods A prospective collection of clinical data from children hospitalized with PNS at the Children's Hospital of the Capital Institute of Pediatrics from January 2021 to October 2022 was conducted. The children were divided into two groups based on the presence of AKI: the AKI group (47 cases) and the non-AKI group (169 cases). The risk factors for AKI in children with PNS were identified by multivariate logistic regression analysis. Urinary KIM-1 and NGAL levels were compared between the AKI and non-AKI groups, as well as among the different stages of AKI. Results The incidence of AKI in children with PNS was 21.8%. Multivariate logistic regression analysis revealed that steroid-resistant nephrotic syndrome, gastrointestinal infections, and heavy proteinuria were independent risk factors for AKI in these children with PNS (P<0.05). Urinary KIM-1 and NGAL levels were higher in the AKI group compared to the non-AKI group (P<0.05), and the urinary NGAL and KIM-1 levels in the AKI stage 2 and stage 3 subgroups were higher than those in the AKI stage 1 subgroup (P<0.017). Conclusions KIM-1 and NGAL can serve as biomarkers for the early diagnosis of AKI in children with PNS. Identifying high-risk populations for AKI in children with PNS and strengthening the monitoring of related risk factors is of significant importance.
Key wordsPrimary nephrotic syndrome    Acute kidney injury    Neutrophil gelatinase-associated lipocalin    Kidney injury molecule-1    Child   
收稿日期: 2024-05-13     
基金资助:北京市医院管理中心“青苗”计划专项经费资助(QML20201309)。
通讯作者: 陈朝英,女,主任医师。Email:chenchaoying484@126.com。     E-mail: chenchaoying484@126.com
作者简介: 高洁,女,硕士研究生,主治医师;
引用本文:   
高洁,陈朝英,涂娟等. 儿童原发性肾病综合征并发急性肾损伤的早期识别[J]. 中国当代儿科杂志, 2024, 26(9): 921-925.
GAO Jie,CHEN Chao-Ying,TU Juan et al. Early identification of acute kidney injury in children with primary nephrotic syndrome[J]. CJCP, 2024, 26(9): 921-925.
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