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06 February 2018, Volume 33 Issue 2 Previous Issue    Next Issue

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Expert consensus on the early management of congenital hydronephrosis in Chinese children Nephrology Group of Pediatric Branch of Shanghai Medical Association，Pediatric Surgery Branch of Shanghai Medical Association，Children’s Hospital of Fudan University，et al 2018, 33(2): 81-88.  DOI: 10.19538/j.ek2018020601 Abstract ( )

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Study on the strategy for early detection of kidney diseases in children XU Hong 2018, 33(2): 89-92.  DOI: 10.19538/j.ek2018020602 Abstract ( )   Chronic kidney disease（CKD） is a global public health problem. Kidney diseases are common in children， most occurring insidiously， while some may progress to CKD in childhood period；the children suffering from kidney diseases are also high-risk groups of adult CKD and end-stage renal disease（ESRD）. Early treatment could prevent and/or delay the occurrence and progress of CKD，so early detection may be a cost-effective solution. It is urgent to explore appropriate strategies for early detection of childhood kidney disease in order to improve the health of children with kidney disease and the prognosis of CKD.

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Paying attention to the kidney injury induced by drugs in children YI Zhu-wen，SHUAI Lan-jun 2018, 33(2): 93-97.  DOI: 10.19538/j.ek2018020603 Abstract ( )   Drug-induced kidney injury is one of the main causes of acute kidney injury in children. Certain drugs can lead to tubular epithelial injury，kidney immune inflammation，or alter the intraglomerular hemodynamics，or cause intrarenal obstruction，which contribute to clinical manifestations including acute kidney injury，acute tubular necrosis，acute or chronic interstitial nephritis，nephrolithiasis/crystal nephropathy，nephrotic syndrome，tubular dysfunction，et al. The setting of several biomarkers are used for prediction and detection of early drug-induced kidney injury. In clinical practice the risk factors of drug-induced kidney injury should be corrected in time and the related drugs be stopped and kidney function be monitored in order to achieve early diagnosis and early intervention，which can improve the prognosis.

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Exploration of renal volume parameters in evaluation of renal function in children WANG Hui，SHEN Ying 2018, 33(2): 98-102.  DOI: 10.19538/j.ek2018020604 Abstract ( )   Renal imaging examination is a necessary method for an early screening or final diagnosis of various types of kidney disease. Objective and accurate measurement of renal volume and virtual reconstruction of renal morphology have important implications for early clinical evaluation of renal function. This article described the progress of renal volume measurement technique and the measurement of renal volume parameters in the field of renal function evaluation in detail. Renal volume parameters are an objective and accurate indicator in renal function evaluation， which has been gradually accepted and applied clinically；more relevant clinical research will also be carried out gradually.

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Obesity-related glomerulopathy in children YANG Hai-ping，LI Qiu 2018, 33(2): 102-105.  DOI: 10.19538/j.ek2018020605 Abstract ( )   With the increasing prevalence of childhood overweight/obesity in the worldwide，obesity-related glomerulopathy（ORG） has become a growing concern among pediatricians. Clinical and pathologic characteristics of ORG are proteinuria，glomerulomegaly，progressive glomerulosclerosis and renal function decline. If not intervened in time，the disease may slowly progress，some of which end in end-stage renal disease. Here we review the recent advances in the pathogenesis and clinical features of ORG，as well as diagnosis and differential diagnosis and potential therapeutic targets.

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Research progress in congenital nephrosis and renal interstitial fibrosis WANG Xiu-li，WU Yu-bin 2018, 33(2): 105-109.  DOI: 10.19538/j.ek2018020606 Abstract ( )   Congenital abnormalies of the kidney and urinary tract（CAKUT） are the main cause of chronic kidney disease （CKD） in childhood. Congenital hydronephrosis is a common type of CAKUT and is usually detected by prenatal renal ultrasonography. Severe congenital nephrosis can cause renal injury and end-stage renal disease（ESRD）. The etiology of congenital nephrosis is complicated and involves the abnormal expression of multiple genes. Studies on human tissue specimens and animal models show that oxidative stress， chronic inflammation and apoptosis result in renal tubular atrophy and renal fibrosis. With advanced biological techniques such as proteomics， new biological markers are emerging for early disease detection and the choice of the optimal treatment and monitoring.

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Acute kidney injury and biomarkers for early diagnosis LI Yan-hong*，FANG Fang 2018, 33(2): 109-113.  DOI: 10.19538/j.ek2018020607 Abstract ( )   Acute kidney injury（AKI） is a common syndrome. Serum creatinine and urine output are the most commonly used in clinical evaluation of kidney injury，but they are poor markers for early diagnosis of AKI，which results in delayed treatment and high mortality. Research in AKI has focused on identifying biomarkers for early detection. Since AKI in children and adults is not the same，investigation is needed to explore the role of potential biomarkers for prediction of AKI in pediatric cohorts. This review serves to update the topic of promising AKI biomarkers and focuses on pediatric biomarker’s advantages and limitations to improve early detection in children.

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Early diagnosis of renal tubular diseases WANG Jing-jing，MAO Jian-hua 2018, 33(2): 113-117.  DOI: 10.19538/j.ek2018020608 Abstract ( )   Hereditary renal tubular disease is insidious and the incidence is relatively low. Renal tubular disease is easy to be overlooked or misdiagnosed due to lack of specific clinical manifestation. The most common clinical manifestations of hereditary renal tubular are hypokalemia，hypercalciuria，polyuria，rickets，and growth retardation. If it is not timely treated，once the renal involvement happened，renal function impairment is generally inconvertible. Therefore，we should pay more attention to the early diagnosis of renal tubular diseases. In order to make early diagnosis，emphasis should be attached to the detailed history，the laboratory examination of renal tubular function series，and the diagnosis clues to hypercalciuria-related renal tubular diseases. It’s necessary for clinical physicians to pay attention to the early diagnosis of tubular diseases in order to perform early intervention and improve prognosis.

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Mitochondria-associated nephropathy ZHANG Ai-hua，CHE Ruo-chen 2018, 33(2): 117-121.  DOI: 10.19538/j.ek2018020609 Abstract ( )   Mitochondrial dysfunction plays a critical role in the pathogenesis of kidney diseases，which can be divided into inherited mitochondrial cytopathy and acquired mitochondrial dysfunction. Mitochondrial cytopathy involves mtDNA point mutations，fragment deletion and rearrangements，mtDNA depletions and nuclear genes mutations. Acquired mitochondrial dysfunction refers to oxidative phosphorylation disorder and decrease of mtDNA copy number due to various causes.All the above-mentioned might induce podocytes injury，tubular dysfunction，interstitial nephropathy，cystic renal diseases as well as carcinoma. At present，the therapy for mitochondrial cytopathy is still deficient.Genetic therapy and mitochondria-targeted protective agents may offer potential treatments for renal diseases.

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Early diagnosis of neonatal acute kidney injury in NICU GONG Hai-rong， CAO Yun，XU Hong 2018, 33(2): 122-126.  DOI: 10.19538/j.ek2018020610 Abstract ( )   Objective　To investigate the morbidity and mortality of neonatal AKI in NICU，evaluate the the performance of the different AKI diagnosis criteria of the Acute Kidney Injury Network （AKIN） and to study the importance of early diagnosis criteria for neonatal AKI. Methods　This is a prospective cohort study performed in NICU，Children Hospital of Fudan University. We prospectively followed the neonates（less than 28 days） admitted from June1st，2012 to August 31，2012，until their discharge or death. For all the neonates we collected the clinical data at admission. Results　AKI was diagnosed in 35 neonates，the incidence of neonatal AKI was 25.73% according to the diagnosis criteria of AKIN in 2012. The mortality of neonatal AKI group was 51.43%（18/35）. Meanwhile，AKI was diagnosed only in 20 neonates，incidence of AKI being 14.71% in the same study with the other diagnosis criteria of AKIN in 2005 and the mortality of neonatal AKI group was 45%（9/20）. Conclusion　AKI is a common and severe clinical problem in NICU with high morbidity and mortality in NICU and is hard to diagnose. The criteria of AKIN in 2012 can improve the early diagnosis of newborn AKI in PICU.

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Correlation analysis between different levels of proteinuria and renal pathological changes in children with IgA nephropathy LUAN Xiao-fei，JIANG Hong 2018, 33(2): 127-130.  DOI: 10.19538/j.ek2018020611 Abstract ( )   Objective　To investigate the correlation between different levels of proteinuria and renal pathological lesion in children with primary IgA nephropathy，in order to provide references for the treatment and condition assessment. Methods　A total of 32 IgAN patients with a renal biopsy from the Pediatric Department of the First Affiliated Hospital of China Medical University from August 2005 to July 2015 were chosen. According to the level of 24 h urinary protein（UP），the 32 cases were separated into 3 groups：mild group（UP＜0.5 g，n＝17），moderate group（0.5-2.0 g，n＝9） and severe group（UP＞2 g，n＝6）. Their clinical and pathological data were studied retrospectively. Results　The proportion of patients with mild，moderate and severe proteinuria were 53.1%， 28.1% and 18.8% respectively. Proteinuria was positively correlated with glomerular integral and tubular interstitial integral（P＜0.05）. The majority of pathological changes of IgAN were grade Ⅱand grade Ⅲ，each with 14 cases（43.8%）. With the increasing level of albuminuria，the degree of pathological damage increased（P＜0.05）. Crescentic lesions were found in 13 cases（40.6%），and with the increasing degree of the proteinuria，the incidence of crescent lesions had an increasing tendency（P＜0.05）. Conclusion　There is correlation between proteinuria and renal pathological changes in children with IgA nephropathy. The level of proteinuria can reflect the pathological damage of glomerular and renal tubule to a certain extent. Children with mild proteinuria，who have IgA nephropathy，also have the potential to progress to ESRD. They need to be treated actively to reduce urinary protein and delay the progression of the disease.

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Change and significance of urinary hydrogen sulfide in the patients with methylmalonic acidemia SONG Jin-qing，LIU Yi，KANG Lu-lu，et al 2018, 33(2): 131-134.  DOI: 10.19538/j.ek2018020612 Abstract ( )   Objective　To investigate the changes and diagnostic value of urinary hydrogen sulfide（H2S） in the patients with methylmalonic acidemia（MMA）. Methods　The urine samples from 20 cases（13 males and 7 females，patient group） of MMA were collected when the patients visited Peking University First Hospital from September 2016 to November 2017. The normal urine samples were collected from 20 healthy children（11 males and 9 females，control group） who had normal development and metabolic condition. H2S in the urine of normal children and MMA children was determined by free radical detector. The differences of urinary H2S concentration between the two groups were analyzed. The ROC curve of urine samples was evaluated. Results　The urinary H2S concentration of the 20 MMA cases was higher than that in the control group（64.9±52.0） μmol/L vs.（43.9±40.0） μmol/L. The difference was significant statistically（Z＝-3.435，P＝0.001）. The area under the curve（AUC） was 0.818 in the ROC curve analysis of MMA with urinary H2S concentration and 47.72 μmmol/L in urine H2S as a cut-off value. The sensitivity and specificity were 95% and 60% respectively. Conclusion　The concentration of urinary H2S is increased in the patients with MMA. Urinary H2S concentration might be a biochemical marker for the early diagnosis MMA in neonatal screening. It is helpful to evaluate the treatment patients and follow-up of MMA.

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Relationship  between  metabolic  syndrome  and  target  organ  damage  of  essential  hypertension  in  children LIN Yao*，SHI Lin，MI Jie，et al 2018, 33(2): 135-139.  DOI: 10.19538/j.ek2018020613 Abstract ( )   Objective　To  study the relationship between metabolic syndrome and target organ damage of essential hypertension in children. Methods　One hundred and sixty-five children older than 10 years were retrospectively enrolled，who were diagnosed with essential hypertension. All children received  examinations of target organ damage. All children were divided into group with metabolic syndrome（Group A，58） and group without metabolic syndrome（Group B，107）. All data were collected and analyzed using statistic methods. Results　In all recruited adolescents，58 patients were diagnosed with metabolic syndrome with the rate of 35.2%. The incidence of target organ damage in Group A（49/58） was significantly higher than Group B（65/107）（84.5% vs. 60.7%，P＜0.05）. The incidence of cardiovascular damage in Group A（28/58） was much higher than Group B（33/107）（48.3% vs. 30.8%，P＜0.05）. The incidence of target organ damage in patients with impaired glucose tolerance was 86.1%（31/36），which was significantly higher than that of patients without it with the rate of 64.3%（83/129）（P＜0.05）. According to the results of multiple factors Logistic regression analysis， metabolic syndrome，course of disease longer than 6 months and elevated average diastolic pressure（≥80 mmHg） were independent risk factors for target organ damage. Conclusion　Essential hypertension children complicated with metabolic syndrome have a much higher incidence of target organ damage than those without metabolic syndrome. Metabolic syndrome is an independent risk factor for target organ damage. The routine examination of metabolic index is beneficial for early diagnosis of target organ damage and effective interference can be performed.

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Effect of digoxin on the invasion ability of non-Hodgkin lymphoma raji cells and its mechanism HOU Yuan-yuan，JIANG Lian，ZHANG Wen-ting，et al 2018, 33(2): 140-144.  DOI: 10.19538/j.ek2018020614 Abstract ( )   Objective　To study the effect of digoxin on the invasion ability of non-hodgkin lymphoma（NHL） raji cells，and to preliminarily investigate its mechanism of action. Methods　The 30 tissue samplec of non-Hodgkin lymphoma were taken in the Pathological Department of the Fourth Hospital of Hebei Medical University from Oct. 2010 to Dec. 2013. （1） The protein expression of Tiam-1 and Rac-1 in NHL were detected by immunohistochemical S-P method. （2）With different concentration of digoxin，the changes in expression levels of Tiam-1 and Rac-1 within raji cells were detected via cell invasion test and qRT-PCR. Results　（1）Immunohistochemical result indicated：the positive rates of protein Tiam-1（70%） and Rac-1（73.33%） in NHL were higher than those in normal lymph node tissues with statistical significance（P＜0.05）. Correlation analysis indicated there was correlation between Tiam-1 and Rac-1，with a correlation coefficient of r＝0.757（P＜0.01）. （2）Cell invasion test indicated：after 48 h treatment by digoxin of different concentrations，the invasion rate reduced with the increasing digoxin concentration，and the results were statistically significant（P＜0.01）. （3）qRT-PCR result indicated：after 48 h treatment by digoxin of different concentrations，statistical difference was observed in the relative expression levels of Tiam-1 and Rac-1 between groups；the relative expression levels reduced with the increasing digoxin concentrations（P＜0.05）. Conclusion　Digoxin，a cardiac glycoside，is able to inhibit lymphoma invasion or metastasis to some extent via regulating the expressions of Tiam-1 and Rac-1.

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Analysis of the serum 25-hydroxyvitamin D level in 2416 children aged from 0 to 14 years old YUAN Jing*，ZHU Ming，ZHAO Xu-sheng，et al 2018, 33(2): 145-147.  DOI: 10.19538/j.ek2018020615 Abstract ( )   Objective　To study and analyze the serum 25-hydroxyvitamin D level in children aged from 0 to 14 years old in Shenyang. Methods　A total of 2416 cases of health children were chosen during January 2016 to December 2016. The level of 25（OH）D was determined by high-performance liquid chromatography tandem mass spectrometry. The data were dealt with SPSS19.0. Results　The level of 25（OH）D in 2416 children was（24.63±10.74） μg/L，in whom the deficiency rate was 18.6%，the insufficiency rate was 16.7%，the sufficiency rate was 64.7%. With the increasing of the age，the level of 25（OH）D had a decreasing tendency. The total abnormal rate of 25（OH）D was 62.5% in＞5-year-old group. The serum 25（OH）D level reached the highest in August and September and the lowest in March and April. Conclusion　The nutrition status of 25（OH）D is great in children aged 0 to 5 years old in Shenyang area. However，it is not optimistic in＞5-year-old group. Therefore it is necessary to raise the awareness of the nutrition status of 25（OH）D in＞5-year-old group. Thus the serum 25-（OH）D level changes significantly with seasons，and should be supplied scientifically and reasonably.

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Iron supplement selection in the treatment of children with nutritional iron-deficiency anemia GAO Hui-ting，HAO Liang-chun 2018, 33(2): 148-151.  DOI: 10.19538/j.ek2018020616 Abstract ( )

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Research progress of microRNA in children with Kawasaki disease CHEN Xue-zhen，QIN Li-jun，WU Ruo-hao，et al 2018, 33(2): 152-155.  DOI: 10.19538/j.ek2018020617 Abstract ( )

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Acute lymphoblastic leukemia complicated with renal invasive fungal disease after chemotherapy：A report of  one case LIU Hui-qing，Lü Hui，WANG Yi 2018, 33(2): 156-157.  DOI: 10.19538/j.ek2018020618 Abstract ( )

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Meat-washing-water-like urine in children with ventricular septal defect after intervention：A report of  two cases LIN Chao, LIN Yue-se, LI Yun-quan, et al 2018, 33(2): 158-160.  DOI: 10.19538/j.ek2018020619 Abstract ( )