臨牀透析 Vol.21 No.10(2)


特集名 小児腎不全 -- 発見から治療まで
題名 腎不全化する先天性腎尿路異常の早期発見
発刊年月 2005年 09月
著者 松山 健 公立福生病院小児科
【 要旨 】 先天性腎尿路異常の臨床的な遭遇機会は多いが,実際に腎不全化するのは両腎に異常を有する場合に限定される.本症の現実的な早期発見手段として各種画像診断法および尿検体を用いる方法があるが,現段階では超音波検査がもっとも適している.発見される実際の疾患群としては閉塞性水腎症,膀胱尿管逆流現象,低形成・異形成腎,各種嚢胞性疾患がある.本症は現検尿システムでは発見されにくいため,今後小児期のいずれかの時期に一度は全員が超音波スクリーニングを受けるシステムの構築が望まれる.
Theme A Total Care of Renal Failure from the Onset in Children
Title Early detection of congenital anomalies of kidney and urinary tract progressing to renal failure
Author Takeshi Matsuyama Department of Pediatrics, Fussa Hospital
[ Summary ] Patients with congenital anomalies of the kidney and the urinary tract (CAKUT) are frequently encountered clinically, but CAKUT actually progressing to renal failure is limited to cases of bilateral renal abnormalities. Various diagnostic imaging techniques and a diagnostic method using urinary samples are used for early detection of CAKUT. However, ultrasonography is the most suitable method for this purpose at this time. A group of diseases, including obstructive hydronephrosis, vesicoureteral reflux, hypoplastic / dysplastic kidney conditions and various cystic diseases may be detected. Since it is difficult for the current urinalysis screening system to detect CAKUT progressing to renal failure, it is hoped that a system will be established whereby all children may undergo ultrasonographic screening any time during infancy.
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