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| 他克莫司致肾病综合征患儿急性肾损伤的高危因素分析 |
| Risks Factors of Tacrolimus induced Acute Renal Injury in Children with Nephrotic Syndrome |
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| DOI： |
| 中文关键词: 他克莫司 急性肾损伤 儿童 肾病综合征 高危因素 |
| 英文关键词:Tacrolimus Acute renal injury Children Nephrotic syndrome High risk factor |
| 基金项目:武汉市卫生计生科研基金项目(编号:WZ18Q03) |
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| 中文摘要: |
| 摘 要 目的：总结分析他克莫司导致肾病综合征 (NS) 患儿发生急性肾损伤 (AKI) 的特点和高危因素。 方法：收集我院因他克莫司导致AKI的7例NS患儿的临床资料、联合用药情况和实验室检查数据，分析该群体发生他克莫司相关AKI的特点。 结果：除1例患儿外，其余6例患儿谷浓度均<10 ng·ml-1。患儿从开始使用他克莫司到发生AKI的时间中位数为14 d。发生AKI后，4例患儿停用他克莫司，3例减量，此后患儿的肾功能均恢复。长期随访发现，除1例患儿由CKD 3期进展为CKD 5期外，其余6例患儿肾功能均稳定在正常水平。 结论：NS患儿发生他克莫司相关AKI的高危因素包括：肾病综合征的未缓解状态、急性胃肠炎、感染和联合用药。存在高危因素的NS患儿使用他克莫司时，应注意监测尿量和肌酐，及时发现AKI情况。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the characteristics and risk factors of tacrolimus induced acute renal injury (AKI) in children with nephrotic syndrome (NS). Methods:The clinical data, combination medications and laboratory data of 7 NS children who suffered from AKI in our hospital were collected retrospectively, and then the characteristics of tacrolimus induced AKI were analyzed. Results:Except for one patient, the tacrolimus trough levels of the other 6 patients were lower than 10 ng·ml-1. Patients developed AKI at a median of 14 days after tacrolimus treatment. All AKI was recovered after tacrolimus reduced in 3 patients and discontinued in 4. After a long term follow up, the renal function of six patients kept normal, whereas one patient with stage 3 CKD progressed to stage 5 CKD. Conclusion:The unrelieved state of NS, acute gastroenteritis, infection and drug combination were the risk factors of tacrolimus induced AKI in NS children. When the above situation occurs in children with NS, urine volume and creatinine should be closely monitored in order to timely recognize tacrolimus induced AKI. |
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