Author/Editor		Novljan, Gregor
Title		Dializno zdravljenje otrok in mladostnikov s končno ledvično odpovedjo
Translated title		Dialysis treatment in children and adolescents with terminal renal failure
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 44, št. 3
Publication year		2005
Volume		str. 315-37
Language		slo
Abstract		Although chronic kidney disease (CKD) is not a typical disease of childhood and its frequency in children is much lower than in adults, it is nevertheless an important health problem in children and adolescents. Based on glomerular filtration rate (GFR), chronic kidney disease is dassified into five stages. The fifth stage of chronic kidney disease is also called terminal renal failure (TRF). Children with chronic kidney disease require chronic substitution treatment. The types of substitution treatment include hemodialysis, peritoneal dialysis and renal transplantation. The incidence of newly discovered children with chronic kidney disease in Slovenia is 7 to 9 per million children a year. The most common causes of chronic kidney disease in small children are hypoplastic or dysplastic kidneys and hereditary nephropathy. ln older children and adolescents, glomerulonephritis (primarily focal segmental glomerulosclerosis) and pyelonephritis are at the forefront. Hemodialysis is a safe and effective method for chronic substitution treatment in children, and good vascular access is of crucial importance for it, while in small children, peritoneal dialysis is chosen more frequently. An important advantage of peritoneal dialysis lies in the fact that patients can do it at home. In addition to dialysis treatment, children with chronic kidney disease also need extensive supportive treatment. Care should be taken to ensure adapted nutrition and appropriate growth and development, as well as to treat anemia, control the metabolism of calcium and phosphate, and regulate blood pressure.
Summary		Čeprav kronična ledvična bolezen (KLB) ni tipična bolezen otroške dobe in je njena pogostnost pri otrocih dosti manjša kot pri odraslih, je vendarle pomemben zdravstveni problem otrok in mladostnikov. Glede na glomerulno filtracijo (GFR) razvrstimo kronično ledvično bolezen v eno od petih stopenj. Kronično ledvično bolezen 5. stopnje imenujemo tudi končno Iedvično odpoved (KLO). Otroci s končno ledvično odpovedjo potrebujejo kronično nadomestno zdravljenje. Oblike nadomestnega zdravljenja so hemodializa, peritonealna dializa in presaditev ledvice. Pojavnost na novo odkritih otrok s končno ledvično odpovedjo je v Sloveniji 7-9/ milijonov otrok letno. Najpogostnejši razlogi za končno ledvično odpoved pri majhnih otrocih so nepravilno razviti ali hipoplastično spremenjeni ledvici in dedne nefropatije. Pri starejših otrocih in mladostnikih je v ospredju glomerulonefritis (predvsem žariščna segmentna glomeruloskleroza) in pielonefritis. Hemodializa je varna in učinkovita metoda kroničnega nadomestnega zdravljenja otrok. Dober žilni pristop je pri tem ključnega pomena. Pri majhnih otrocih se pogosteje odločimo za peritonealno dializo. Pomembna prednost peritonealne dialize je v tem, da ju bolniki lahko izvajajo doma. Poleg dializnega zdravljenja putrebujejo otroci s končno ledvično odpovedjo tudi obsežno podporno zdravljenje. Skrbimo za prilagojeno prehrano, primerno rast in razvoj, zdravimo slabokrvnost, nadziramo presnovo kalcija in fosfata ter urejamo krvni tlak.
Descriptors		KIDNEY FAILURE, CHRONIC HEMODIALYSIS PERITONEAL DIALYSIS PERITONEAL DIALYSIS, CONTINUOUS AMBULATORY CHILD ADOLESCENCE