摘要儿童慢性肾功能不全的严重后果不仅是进展为终末期肾衰竭需要肾脏替代治疗,而且也明显增加心血管疾病、代谢综合征等并发症的危险性,因此对慢性肾功能不全的早期诊断尤为重要.临床医师常通过血肌酐、尿素氮等传统监测指标评估患儿肾功能,但传统的评估指标具有一定滞后性,目前国际上常用胱抑素C、血尿β2微球蛋白等指标评价儿童肾功能.由于不同性别、不同年龄儿童肾小球滤过率不是恒定值,用化验指标很难准确估计儿童肾功能,因此需要与肾小球滤过率评估公式相结合,才能准确评估肾脏损害程度,并为防止肾功能进展到终末期提供干预治疗最好的时机.该文对几种常用的儿童肾功能评估方法进行概述,以寻求出适用于我国儿童的肾功能评估方法及标准.

abstractsPediatric kidney disease prevalence has increased over the past decades.The key result of children with chronic kidney disease (CKD) is end-stage renal disease (ESRD) who needs renal replacement therapy with significantly increased risk of cardiovascular disease and metabolic syndrome.It is essential to diagnose CKD in the early phase by assessment of kidney function.We assess the kidney function by detecting serum creatinine(SCr) and blood urea nitrogen(BUN),which are traditional biomarkers and not sensitive to diagnose AKI.We also use cystatin C and β2-microglobulin to evaluate kidney function,which are controversial in clinic.It is difficult to evaluate kidney function exactly for children because glomerular filtration rate(GFR) is different in children with different age and gender.It should be more sensitive and specific to assess pediatric kidney function by applying blood and urine biomarkers and GFR equation together.Nowadays,we should find a more precise equation to evaluate GFR for children in order to monitor the kidney disease progression.It may provide the exact timing for the treatment to prevent ESRD.Therefore,we summarize some GFR equations in order to detect more suitable equation to evaluate GFR for Chinese children with different age,gender and nutrition status.