Abstract:
Glomerular diseases are common causes of chronic kidney disease in childhood, adolescence, and adulthood. The epidemiology of glomerular diseases differs between different age groups, with minimal change disease being the leading cause of nephrotic syndrome in childhood, while membranous nephropathy and focal segmental glomerulosclerosis are more common in adulthood. IgA vasculitis is also more common in childhood. Moreover, there is a difference in disease severity with more children presenting with a relapsing form of nephrotic syndrome and a more acute presentation of antineutrophil cytoplasmic antibody-associated vasculitis and concomitant glomerulonephritis, as highlighted by the higher percentage of cellular crescents on kidney biopsy specimens in comparison with older patients. There is also a female preponderance in antineutrophil cytoplasmic antibody-associated vasculitis and more children present with tracheobroncholaryngeal disease. This article aims to summarize differences in the presentation of different glomerular diseases that are encountered commonly by pediatric and adult nephrologists and potential differences in the management.
摘要:
肾小球疾病是儿童慢性肾病的常见原因,青春期,和成年。肾小球疾病的流行病学在不同年龄段之间存在差异,微小变化疾病是儿童肾病综合征的主要原因,而膜性肾病和局灶性节段性肾小球硬化在成年期更为常见。IgA血管炎在儿童时期也更常见。此外,疾病严重程度存在差异,更多的儿童表现为肾病综合征的复发形式,以及抗中性粒细胞胞浆抗体相关血管炎和并发肾小球肾炎的更急性表现。与老年患者相比,肾脏活检标本上的细胞新月体百分比更高。在抗中性粒细胞胞质抗体相关血管炎中也有女性优势,并且更多的儿童患有气管支气管胆总管疾病。本文旨在总结儿科和成人肾脏病学家常见的不同肾小球疾病的表现差异以及管理方面的潜在差异。