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Kev paub

Yuav ua li cas kom tsis txhob muaj kab mob hauv lub raum thaum yau?

Mar 12, 2022

Ntiaj teb lub raum hnub 2016. Averting lub legacy ntawm lub raum kab mob- tsom ntsoov rau thaum yau

TSAB NTAWV

Ntiaj teb lub raum Hnub 2016 tsom raumob raumnyob rau hauv me nyuam yaus thiab cov ntecdents ntawm cov neeg lausmob raumuas tuaj yeem pib thaum yau tshaj plaws. Ntevmob raum(CKD) hauv menyuam yaus txawv ntawm qhov ntawd hauv cov neeg laus, vim tias pawg kuaj mob loj tshaj plaws ntawm cov menyuam yaus suav nrog kev tsis sib haum xeeb thiab xeeb tub, nrog rau glomeruli lipathies thiabmob raumnyob rau hauv qhov teeb meem ntawm ntshav qab zib yog qhov tsis tshua muaj. Tsis tas li ntawd, ntau tus menyuam yaus uas mob raum raug mob thaum kawg yuav tsim qhov tshwm sim uas yuav ua rau muaj ntshav siab thiab CKD tom qab menyuam yaus lossis hauv neeg laus lub neej. Cov me nyuam yug ntxov los yog me me- rau hnub yug me nyuam muaj kev pheej hmoo rau kev loj hlob ntawm CKD tom qab lub neej. Cov neeg uas muaj kev pheej hmoo siab yug thiab ntxovthaum yaukeeb kwm yuav tsum tau saib xyuas kom zoo txhawm rau txhawm rau txhawm rau txheeb xyuas cov cim qhia ntxovmob raumnyob rau hauv lub sij hawm los muab kev tiv thaiv zoo los yog kev kho mob. Kev kho tau zoo yog ua tau rau kev kho mob CKD hauv cov menyuam yaus; muaj pov thawj tias cov menyuam yaus zoo dua li cov neeg laus, yog tias lawv tau txais kev kho mob raum nrog rau kev lim ntshav thiab hloov pauv, thaum tsuas yog ib feem ntawm cov menyuam yaus yuav xav tau qhov kev pabcuam kawg no vim tias muaj kev tsis sib xws hauv kev saib xyuas, yuav tsum siv zog kom cov cov me nyuam nrogmob raum, nyob qhov twg lawv nyob, tej zaum yuav kho tau zoo, tsis hais txog lawv thaj chaw lossis kev lag luam. Peb qhov kev cia siab yog tias Hnub Ntiaj Teb Lub Raum yuav qhia rau cov pej xeem, cov neeg tsim cai, thiab cov neeg saib xyuas txog cov kev xav tau thiab kev muaj peev xwm nyob ib puag ncig.mob raumhauvthaum yau.

Hu rau:joanna.jia@wecistanche.com


Averting the legacy of kidney disease-focus on childhood

cistanche tuaj yeem txo cov keeb kwm ntawm cov kab mob raum ntawm cov menyuam yaus

Kev Taw Qhia thiab Txheej Txheem

Qhov 11thNtiaj teb lub raum Hnub yuav ua kev zoo siab rau lub Peb Hlis 10, 2016, thoob plaws ntiaj teb. Qhov kev tshwm sim txhua xyoo, txhawb nqa ua ke los ntawm International Society of Nephrology (ISN) thiab International Federation of Kidney Foundations (IFKF), tau dhau los ua kev ua tiav zoo los qhia rau cov pej xeem thiab cov neeg tsim cai txog qhov tseem ceeb thiab kev cuam tshuam ntawmmob raum. Xyoo 2016, Ntiaj Teb Lub Raum Hnub yuav muab siab raumob raumnyob rau hauv thaum yau thiab cov antecdents ntawm cov neeg laus kab mob raum, uas yuav pib nyob rau hauv thaum yau.

Cov menyuam yaus uas raug mob raum mob hnyav (AKI) los ntawm ntau yam mob tuaj yeem muaj cov kab mob ntev ntev uas tuaj yeem ua rau mob ntev.mob raum(CKD) ntau xyoo tom qab.1-4Tsis tas li ntawd, CKD hauvthaum yauFeem ntau ntawm nws congenital, thiab teeb meem los ntawm ntau yam kab mob uas tsis yog lub raum uas tuaj yeem cuam tshuam rau ob lub raum thib ob, tsis yog tsuas yog ua rau muaj mob hnyav thiab tuag thaum menyuam yaus tab sis kuj ua rau muaj teeb meem kho mob dhau mus.thaum yau. Qhov tseeb tiag, kev tuag ntawm menyuam yaus los ntawm cov npe ntev ntawm cov kab mob sib kis tsis tau txuas nrog rau lub raum kev koom tes. Piv txwv li, cov me nyuam uas succumb rau tus kab mob cholera thiab lwm yam kab mob raws plab feem ntau tuag, tsis yog los ntawm tus kab mob, tab sis vim AKI induced los ntawm ntim depletion thiab poob siab. Tsis tas li ntawd, cov ntaub ntawv tseem ceeb ntawm lub cev qhia tau hais tias mob ntshav siab, proteinuria, thiab CKD hauv cov neeg laus muaj cov menyuam yaus ua ntej txij thaum ntxov hauv lub tsev menyuam thiab lub neej hauv plab (saib Table 1 rau cov ntsiab lus ntawmthaum yau). Ntiaj Teb Lub Raum Hnub 2016 lub hom phiaj los txhawb kev paub dav dav tias ntau tus neeg mob lub raum tau pib thaum yau. Nkag siab txog kev kuaj mob thiab cov xwm txheej uas tshwm sim hauv menyuam yaus muaj peev xwm txheeb xyuas thiab cuam tshuam rau cov neeg uas muaj kev pheej hmoo siab dua rau CKD thaum lawv lub neej.

Cov ntaub ntawv kis mob thoob ntiaj teb ntawm cov spectrum ntawm ob qho tib si CKD thiab AKI hauv cov menyuam yaus tam sim no raug txwv, txawm tias nce ntxiv. Feem ntau ntawm CKD hauvthaum yautsis tshua muaj-thiab tau tshaj tawm ntau yam ntawm 15-74.7 ib lab tus menyuam.3Qhov kev hloov pauv zoo li no yuav yog vim cov ntaub ntawv ntawm CKDare cuam tshuam los ntawm cov xwm txheej hauv cheeb tsam thiab kab lis kev cai, nrog rau cov txheej txheem siv los tsim lawv. Lub Koom Haum Ntiaj Teb Kev Noj Qab Haus Huv (WHO) tsis ntev los no tau ntxiv cov kab mob raum thiab cov kab mob urological rau cov ntaub ntawv tuag tau taug qab thoob ntiaj teb thiab yuav tsum yog qhov muaj txiaj ntsig ntawm cov ntaub ntawv zoo li lub sijhawm-tsis tau WHO tsis tshaj tawm cov ntaub ntawv los ntawm pawg hnub nyoog. 5 Databases xws li North American Pediatric Renal Trials thiab Collaborative Studies (NAPRTCS)6 US Renal Data System (USRDS)7 thiab EDTA cov npe8suav nrog cov ntaub ntawv ntawm cov menyuam yaus ESRD, thiab qee qhov ntawm CKD. Cov haujlwm xws li Ital Kid9 thiab ChronicKab mob raumHauv Me Nyuam (CKiD)10cov kev tshawb fawb, Kev Tshawb Fawb Ntiaj Teb Kev Tshawb Fawb Txog Kab Mob 2013, nrog rau cov npe uas tam sim no muaj nyob hauv ntau lub teb chaws muab cov ntaub ntawv tseem ceeb, thiab xav tau ntau ntxiv.

AKI tuaj yeem ua rau CKD, raws li kev tshawb fawb cov neeg laus xaiv.12 Qhov tshwm sim ntawm AKI ntawm cov menyuam yaus uas tau txais mus rau hauv chav saib xyuas mob hnyav sib txawv - los ntawm 8 feem pua ​​​​rau 89 feem pua.1Qhov tshwm sim yog nyob ntawm cov peev txheej muaj. Cov txiaj ntsig tau los ntawm cov haujlwm xws li AWARE txoj kev tshawb fawb, kev tshawb fawb tsib lub tebchaws ntawm AKI hauv cov menyuam yaus tau tos.13Cov kev tshawb fawb ib leeg, nrog rau cov kev ntsuam xyuas meta, qhia tias ob qho tib si AKI thiab CKD hauv cov menyuam yaus suav rau cov neeg tsawg ntawm CKD thoob ntiaj teb.2,3Txawm li cas los xij, nws yog qhov tseeb ntxiv tiasmob raumnyob rau hauv neeg laus feem ntau springs los ntawm ibthaum yaukeeb kwm.

Lub spectrum ntawm Pediatric raum Kab Mob

Cov xwm txheej uas suav rau CKD hauvthaum yau, nrog ib tug predominance ntawm congenital thiab hereditary disorders, txawv heev ntawm cov neeg laus. Txog niaj hnub no, kev hloov pauv hauv ntau dua 150 cov noob tau pom los hloov kho lub raum kev loj hlob lossis cov haujlwm glomerular lossis tubular.14 Feem ntau ntawm cov kab mob caj ces no tshwm sim thaum lub sijhawmthaum yau, thiab tej zaum yuav ua rau muaj kev vam meej CKD. Congenital anomalies ntawm lub raum thiab urinary ib ntsuj av (CAKUT) account rau cov loj tshaj plaws qeb ntawm CKD nyob rau hauv cov me nyuam (saib Table 2) thiab suav nrog rau lub raum hypoplasia / dysplasia thiab obstructive uropathy. Cov pab pawg tseem ceeb ntawm lub raum dysplasia yog cystickab mob raum, uas tshwm sim los ntawm caj ces tsis xws luag ntawm tubule epithelial cells 'prim cilia. Ntau tus menyuam yaus glomerulopathies yog tshwm sim los ntawm caj ces los yog tau txais qhov tsis xws luag ntawm cov podocytes, hom cell tshwj xeeb hauv ob sab phlu glomerular capillaries. Tsawg dua tab sis tseem ceeb ua rauthaum yauCKD yog cov kab mob metabolic xws li hyperoxaluria thiab cystinosis, thiab atypical hemolytic uremic syndrome, thrombotic microangiopathy ntsig txog caj ces abnormalities ntawm complement, coagulation, los yog metabolic txoj kev.

The data in this table are as defined by the World Health Organization. The perinatal period is defined as 22 completed weeks of gestation to Day 7 of life; the neonatal period, as up to 28 days of life; infancy as up to one year of age; childhood as year 1 to 10; and adolescence from 10 years to age 19. There is variation worldwide in how these stages of early life are defined. Some would define Etiology of Chronic Kidney Disease in Children

Hauv ntau qhov kev faib tawm, nws tsis paub meej tias yuav ua li cas cais cov menyuam yaus uas raug kev txom nyem AKI thiab pom tau zoo, lossis yuav ua li cas thiab seb puas suav nrog cov menyuam yaus uas muaj teeb meem perinatal, yuav ua rau muaj tus lej nephron tsawg.

Ntawm cov me nyuam nrogthaum yau-onset end-stage renal disease (ESRD), glomerulopathies yog me ntsis ntxiv thiab congenital anomalies tsawg dua (Table 2), vim qhov feem ntau sai dua nephron poob hauv cov kab mob glomerular. Txawm li cas los xij, cov pov thawj tsis ntev los no qhia tau hais tias ntau tus neeg mob uas muaj mob me me ntawm CAKUT tuaj yeem nce mus rau ESRD thaum muaj hnub nyoog laus, nce siab hauv xyoo kaum plaub ntawm lub neej.15

Muaj qhov sib txawv hauv tebchaws thiab cheeb tsam hauv hom thiab cov chav kawm ntawm AKI thiab CKD thaum lub sijhawmthaum yauthiab tshaj. Tuag los ntawmmob raumyog siab dua nyob rau hauv cov teb chaws tsim, thiab lub teb chaws thiab cheeb tsam tsis sib xws ntawm kev saib xyuas thiab cov txiaj ntsig yuav tsum tau hais txog. Tsis tas li ntawd, kev nkag mus rau kev saib xyuas yog qhov sib txawv, nyob ntawm thaj tsam, lub teb chaws, thiab nws cov infrastructure. Los ntawm kev tsom mus raumob raumhauvthaum yau, cov kev daws teeb meem raug nqi yuav raug mus txog, raws li kev kho tus kab mob ntxov thiab preemptively tuaj yeem tiv thaiv tom qab, ntau dua CKD. Kev cia siab nyob ntawm qhov muaj kev saib xyuas thiab kev tswj xyuas. Kev kho cov menyuam yaus, txawm tias me nyuam mos, uas muaj AKI thiab CKD uas xav tau kev kho lub raum hloov tuaj yeem ua tau zoo los txo cov kab mob raum rau cov neeg laus. Ua li ntawd yuav tsum muaj cov peev txheej uas tsom mus rau txoj hauv kev nrawm tshaj plaws thiab raug nqi kom xa cov RRT mob hnyav hauvthaum yau.

to relieve the chronic kidney disease

Congenital Kidney Disease and Developmental Origins of Health and Disease, Renal Endowment and Implications

Hauv cov cheeb tsam uas antenatal fetal ultrasounds niaj hnub, ntau cov menyuam yaus uas muaj qhov txawv txav ntawm urological raug txheeb xyuas, uas tso cai rau kev cuam tshuam ntxov. Txawm li cas los xij, hauv ntau lub ntiaj teb, cov menyuam yaus uas muaj qhov txawv txav tsis raug txheeb xyuas kom txog thaum ntau tom qab, thaum cov tsos mob tshwm sim. Thaum kev tshuaj ntsuam xyuas dav dav rau cov proteinuria, hematuria, thiab cov kab mob urinary tau ua nyob rau qee lub tebchaws thiab cheeb tsam, tsis muaj kev pom zoo rau nws cov txiaj ntsig. Txawm li cas los xij, muaj kev pom zoo dav dav tias cov menyuam yaus nrog kev tshawb fawb antenatal ultrasound uas qhia tau tias muaj peev xwm genitourinary anomalies, cov menyuam yaus uas muaj keeb kwm ntawm tsev neeg.mob raum, thiab cov menyuam yaus uas muaj cov tsos mob xws li tsis muaj kev vam meej lossis keeb kwm ntawm cov kab mob urinary tract, voiding dysfunction, los yog cov zis txawv txav yuav tsum tau kuaj xyuas. Kev tshuaj ntsuam thawj zaug yuav suav nrog kev tshuaj xyuas lub cev tsom mus thiab tso zis tso zis, kev kuaj zis, thiab ib qho yooj yim chemistry vaj huam sib luag, tom qab ntawd los ntawm kev ntsuam xyuas ntau dua yog qhia.

Nyob ntawm qhov kev kuaj mob, kev kho kom meej meej yuav raug qhia. Txawm li cas los xij, cov pov thawj tias kev kho mob yuav ua rau qeeb ntawm CKD hauvthaum yautseem txwv. Angiotensin-hloov enzyme inhibitors, angiotensin receptor blockers, antioxidants, thiab, tejzaum nws, kev noj zaub mov hloov yuav raug qhia, nyob ntawm qhov kev kuaj mob. Txawm li cas los xij, kev hloov pauv kev noj haus yuav tsum tso cai rau kev loj hlob thiab kev loj hlob. Qhov kev sim ESCAPE tau muab pov thawj tias kev tswj ntshav siab nruj ua rau txo qis kev loj hlob ntawm CKD hauv cov menyuam yaus tsis hais txog hom mob hauv qab.mob raum.16

Qee cov menyuam yaus yuav xav tau kev kho lub raum hloov thaum ntxov. Cov ntaub ntawv tsis ntev los no tau sau los ntawm cov ntawv sau npe thoob ntiaj teb qhia tias muaj sia nyob zoo, txawm tias yuav tsum tau lim ntshav los ntawm lub hnub nyoog neonatal.2,17 raum hloov pauv, kev kho lub raum zoo rau cov menyuam yaus, feem ntau tsim nyog tom qab hnub nyoog 12 lub hlis, nrog rau tus neeg mob zoo heev thiab muaj sia nyob, kev loj hlob. , thiab kev loj hlob.

Cov ntaub ntawv pov thawj yog accumulatingthaum yau- pib CKD ua rau kom ceev cov hlab plawv thiab lub neej expectancy luv. Cov kev tshawb fawb loj uas txuas mus ntxiv xws li (Kev Mob Ntshav Qab Zib hauv Cov Me Nyuam nrog CKD (4C) Txoj Kev Kawm yuav tsum qhia txog cov laj thawj thiab qhov tshwm sim ntawm cov kab mob plawv ntxov hauv cov menyuam yaus nrog CKD.18

Ntxiv rau cov me nyuam uas congenitalmob raum, tam sim no paub tias cov xwm txheej perinatal tuaj yeem cuam tshuam kev noj qab haus huv yav tom ntej hauv qhov tsis muaj pov thawjmob raumthaum ntxov ua neej nyob.19 Cov me nyuam mos ntxov ntxov zoo li muaj kev pheej hmoo tshwj xeeb raumob raumntev tom qab lawv yug los, raws li ob qho tib si ntawm kev soj ntsuam kev tshawb fawb, nrog rau cov ntaub ntawv ceeb toom. Ntau tus menyuam mos ntxov ntxov ciaj sia, suav nrog ntau tus menyuam yug los zoo ua ntej nephrogenesis tiav.20Cov ntaub ntawv txwv tsis pub muaj qhia tau hais tias nyob rau hauv cov txheej txheem ntawm kev saib xyuas ICU, cov menyuam yaus no tau txais ntau yam nephrotoxins thiab cov neeg tuag ua ntej tso tawm hauv tsev zov me nyuam muaj tsawg dua thiab loj dua glomeruli.21 Tsis tas li ntawd, cov uas tseem muaj sia nyob muaj pov thawj ntawm lub raum tsis zoo uas tej zaum yuav hloov maj mam.22Txawm hais tias muaj kev txhawj xeeb ntau dua, cov ntaub ntawv muaj kab mob sib kis ntau qhia tau hais tias cov neeg yug los ntawm lub sijhawm tab sis nrog qhov hnyav thaum yug me nyuam yuav muaj kev pheej hmoo siab rau ntshav siab, albuminuria, thiab CKD hauv lub neej tom qab.23 Thaum kev ntsuas ncaj qha, cov neeg zoo li no, xws li cov neeg laus, yuav muaj tsawg dua nephrons, yog li cov nyiaj pab qis qis.

Hauv kev tsom mus rau cov menyuam yaus rau Hnub Ntiaj Teb Lub Raum, peb yuav nco ntsoov tias nws yog qhov tseem ceeb ua raws li lub raum ua haujlwm thiab ntshav siab thoob plaws lub neej ntawm cov neeg uas yug ntxov lossis me me rau hnub. Los ntawm kev ua li ntawd, thiab zam cov tshuaj nephrotoxic thoob plaws hauv lub neej, nws tuaj yeem tiv thaiv CKD hauv ntau tus neeg.

Kev Pabcuam thiab Kev Kho Mob rau Menyuam Yaus-Qhov txawv ntawm Kev Kho Mob rau Cov Neeg Laus

Kev tsis sib xws muaj nyob hauv qhov muaj peev txheej los kho AKI hauv cov menyuam yaus thiab cov tub ntxhais hluas; Yog li ntawd, ntau tus menyuam yaus thiab cov tub ntxhais hluas hauv cov teb chaws tsim kev puas tsuaj yog AKI tshwm sim. Txhawm rau daws qhov teeb meem ISN tau pib Txoj Haujlwm Txuag Hluas Lub Neej, uas yog ob qho tib si los tiv thaiv AKI nrog kev kho mob sai sai thiab / lossis xa cov kua dej tsim nyog thiab electrolyte, thiab kho AKI thaum nws tshwm sim. Txoj haujlwm txuas ntxiv no hauv Sub-Saharan Africa thiab Southeast Asia, uas muaj plaub lub hauv paus raum koom nrog sib npaug (IPNA, ISN, ISPD, thiab SKCF), . Nws txuas nrog ISN's 0 los ntawm 25 qhov project, uas hu rau cov tswv cuab los xyuas kom meej txog 2025 tias tsis muaj leej twg tuag los ntawm kev tiv thaiv thiab mob raum mob.

Raws li kev pom ntawm qhov muaj feem cuam tshuam ntawm kev yug me nyuam thiab keeb kwm tsis zoo, kev kho mob rau cov menyuam yaus nrog CKD muaj keeb kwm raug txwv rau qee qhov kev tiv thaiv kab mob. Tsis ntev los no, kev nce qib hauv kev txhim kho tshuaj hauv kev hais kwv txhiaj nrog kev nce qib hauv kev paub txog caj ces thiab kev kuaj mob muaj peev xwm tau pib kov yeej 'kev kho mob nihilism' ntev ntev hauv cov menyuam yaus.mob raum. Atypical HUS, ntev suav tias yog qhov tsis zoo, nrog qhov muaj feem ntau ntawm kev nce mus rau ESRD thiab tom qab hloov pauv hloov pauv, tau hloov mus rau hauv cov xwm txheej kho tau-nrog rau qhov tshwm sim ntawm monoclonal antibody uas tshwj xeeb thaiv C5 ua kom muaj zog.2424 Lwm qhov piv txwv yog kev siv vasopressin receptor antagonists rau retard cyst kev loj hlob thiab khaws cia lub raum ua haujlwm hauv polycystic.mob raum.25Thawj qhov ua pov thawj ua tau zoo hauv cov neeg laus nrog autosomal dominant polycysticmob raum, kev kho mob nrog vaptans tuav cov lus cog tseg rau daim ntawv rov qab ntawm tus kab mob, uas nthuav tawm thiab feem ntau nce mus rau ESRD thaum lub sijhawmthaum yau.

Txawm li cas los xij, cov neeg mob tau txais txiaj ntsig los ntawm kev tshawb fawb tshuaj kho mob tau ua rau muaj kev puas tsuaj thoob ntiaj teb los ntawm tus nqi loj ntawm qee cov tshuaj kho tshiab. Qhov kev tshawb nrhiav rau cov kev kho tshiab pheej yig rau cov kab mob tsawg yuav yog qhov teeb meem tseem ceeb hauv cov menyuam yaus nephrology hauv xyoo tom ntej.

Kev txheeb xyuas cov menyuam yaus yuav tau txais txiaj ntsig los ntawm cov txheej txheem kho tshiab yuav pab tau zoo heev los ntawm kev txhim kho cov chaw kho mob uas qhia txog cov kab mob ntuj, suav nrog kev sib raug zoo ntawm genotype-phenotype. Sib nrug los ntawm cov kab mob tshwj xeeb cov ntaub ntawv, kuj tseem xav tau cov npe kho mob tshwj xeeb. Cov no yog qhov tshwj xeeb tshaj yog nyob rau hauv cov cheeb tsam uas qhov kev sim tshuaj tsis yooj yim los ua vim muaj cov neeg mob me me thiab tsis muaj kev txaus siab rau kev lag luam, nrog rau cov kev kho mob uas xav tau kev txhim kho thoob ntiaj teb lossis kev txhim kho. Piv txwv li, tam sim no muaj qhov loj thoob ntiaj teb gradient nyob rau hauv kev nkag mus thiab kev ua tau zoo ntawm pediatric dialysis thiab transplantation. Thaum tus neeg mob thiab cov txheej txheem ciaj sia taus zoo heev thiab txawm tias zoo tshaj rau cov neeg laus hauv ntau lub teb chaws industrialized, nws tau kwv yees tias yuav luag ib nrab ntawm lub ntiaj teb.thaum yaucov pej xeem tsis muaj kev kho mob raum tsis zoo (RRT) txhua. Muab kev nkag mus rau RRT rau txhua tus menyuam yaus yuav yog qhov nyuaj heev rau yav tom ntej. Txhawm rau kom tau txais cov ntaub ntawv txhim khu kev qha ntawm cov pej xeem thiab cov txiaj ntsig ntawm cov menyuam yaus RRT, International Pediatric Nephrology Association (IPNA) tab tom yuav tshaj tawm cov npe pej xeem thoob ntiaj teb. Yog tias ua tiav, IPNA RRT npe yuav dhau los ua tus qauv rau kev sau cov ntaub ntawv thoob ntiaj teb.

Resources and Therapeutics for Children-Differences from Therapeutics in Adults in kidney disease

Kev hloov ntawm Pediatric mus rau Kev Saib Xyuas Neeg Laus

Kev hloov ntawm kev saib xyuas rau cov tub ntxhais hluas nrogmob raumnyob rau hauv ib tug neeg laus qhov chaw yog ib qho tseem ceeb rau cov neeg mob thiab lawv cov neeg zov me nyuam. Kev tsis ua raws cai yog ib qho tseem ceeb heev ntawm kev hloov pauv ntawm cov menyuam yaus mus rau kev saib xyuas neeg laus rau cov neeg mob hluas uas muaj kab mob ntev hauv xeev.26-28 Yog li, suav nrog cov kauj ruam ua ke nrog cov txheej txheem uas tau teev tseg raws li kev txhawb nqa los ntawm txoj hauv kev siv tau thiab cov txheej txheem kev ntseeg siab yuav tsum muaj nyob rau hauv qhov chaw. xyuas kom muaj kev vam meej.

Nyob rau hauv tus txheej txheem ntawm kev hloov ntawm cov me nyuam mus rau cov neeg laus saib xyuas "kev hloov," uas yuav tsum tshwm sim maj mam, yuav tsum tau txawv ntawm "hloov", uas yog feem ntau yog ib tug abrupt thiab mechanistic hloov nyob rau hauv lub chaw muab kev pab. Kev nthuav qhia lub tswv yim ntawm kev hloov pauv yuav tsum yog preemptive, pib lub hlis mus rau xyoo ua ntej lub sijhawm teem tseg, vim tias cov menyuam yaus txav mus rau hauv cov hluas thiab cov neeg laus. Lub hom phiaj ntawm qhov kawg yog txhawb kom muaj kev sib raug zoo thiab kev npaj ua tus kheej hauv qhov chaw tshiab uas tso cai rau tus neeg mob kom xis nyob txaus los qhia txog kev tsis ua raws li kev coj ua thiab lwm yam lapses hauv kev saib xyuas.

Txoj kev hloov pauv yuav tsum lees paub tias qhov kev xav loj hlob ntawm cov me nyuam nrogmob raumyuav txawv dav. Kev soj ntsuam ntawm tus neeg saib xyuas thiab tsev neeg cov qauv, nrog rau kev coj noj coj ua, kev sib raug zoo, thiab nyiaj txiag thaum lub sijhawm hloov pauv, yog qhov tseem ceeb, suav nrog kev ntsuas qhov tseeb ntawm tus neeg saib xyuas lub nra.4Lub sijhawm tsim nyog thiab hom kev hloov pauv tuaj yeem sib txawv ntawm cov neeg mob sib txawv thiab hauv cov chaw sib txawv; yog li ntawd, cov txheej txheem hloov pauv yam tsis muaj hnub teem sijhawm thiab txawm tias tsis muaj hom ntawv teev npe yuav raug nyiam.

Qhov tseem ceeb, qhov kev hloov pauv yuav tsum tau ua kom qeeb, ncua, lossis rov thim rov qab ib ntus thaum muaj kev kub ntxhov xws li kab mob flares lossis kev loj hlob, lossis yog tsev neeg lossis kev tsis sib haum xeeb tshwm sim. Daim ntawv tshaj tawm kev pom zoo tsis ntev los no los ntawm International Society of Nephrology (ISN) thiab International Pediatric Nephrology Association (IPNA) tau npaj cov kauj ruam raws li cov ntsiab lus tau hais tseg, txhawm rau txhim kho kev hloov pauv ntawm kev saib xyuas hauvmob raumhauv kev kho mob.29,30

Hu rau tsim cov ntaub ntawv ntxiv thiab Kev Ua Haujlwm

Muab cov vulnerabilities ntawm cov me nyuam nrogmob raumsuav nrog kev cuam tshuam rau kev loj hlob thiab kev loj hlob thiab lub neej yav tom ntej raws li ib tug neeg laus, thiab muab ntau qhov kev faib ua feem ntawm cov menyuam yaus hauv cov teb chaws uas tab tom ntsib cov kev txwv tsis pub muaj kev qhia txhua tus neeg koom nrog yog qhov tseem ceeb txhawm rau txhawm rau txhim kho kev sib txuas lus thiab kev ua..31,32Cov kev siv zog no yuav tsum txhawb nqa kev sib koom tes hauv cheeb tsam thiab thoob ntiaj teb thiab kev sib pauv tswv yim ntawm lub hauv paus raum hauv zos, cov koom haum ua haujlwm, lwm cov koom haum tsis muaj txiaj ntsig, thiab xeev thiab tsoomfwv, txhawm rau pab txhawb txhua tus neeg koom nrog txhawm rau txhim kho kev noj qab haus huv, kev noj qab haus huv, thiab lub neej zoo ntawm cov me nyuam nrogkab mob raumthiab xyuas kom lawv lub neej ntev mus rau kev laus.

Txog tam sim no, txawm li cas los xij, WHO cov lus pom zoo rau cov kab mob tsis sib kis (NCD) suav nrog kab mob plawv, mob qog noj ntshav, ntshav qab zib, thiab kab mob ua pa ntev, tab sis tsis yog.mob raum.33,34_ENREF_9. Hmoov zoo, vim, ib feem, rau kev sib tw thoob ntiaj teb coj los ntawm ISN, Kev Tshaj Tawm Tshaj Tawm Txog NCDs los ntawm United Nations Summit hauv 2011 tau hais.mob raumnyob rau hauv nqe lus 19.35

Txhim kho kev kawm thiab kev paub txog kab mob raum nyob rau hauv dav dav thiabmob raumhauvthaum yau, tshwj xeeb tshaj yog, ua raws li lub hom phiaj ntawm WHO kom txo qis kev tuag los ntawm NCD nrog rau 10- lub hom phiaj ntawm cov pej xeem-theem thawj zaug tsom rau kev hloov pauv hauv kev ua neej (xws li kev txo qis kev haus luam yeeb, kev noj ntsev, kev noj zaub mov noj, thiab Kev txo qis cawv) thiab kev cuam tshuam zoo (xws li ntshav siab, cholesterol thiab glycemic tswj). Kev siv zog ntau ntxiv yog xav tau los kho dua tshiab thiab nthuav dav cov kev sib koom tes ntawm ntau qhov kev qhuab qhia nrog rau kev tsom mus rau kev tshawb pom ntxov thiab kev tswj xyuas.mob raumhauv cov menyuam yaus. Hos cov teeb meem ntsig txogmob raumTej zaum yuav raug cuam tshuam los ntawm lwm cov NCDs uas pom tias muaj kev cuam tshuam loj dua rau pej xeem kev noj qab haus huv xws li ntshav qab zib, mob qog noj ntshav, thiab kab mob plawv, peb cov kev siv zog yuav tsum tau nce kev kawm thiab kev paub txog cov xwm txheej sib tshooj xws li kev sib txuas hauv plawv, lub ntiaj teb xwm txheej ntawm CKD thiab ESRD ua NCDs loj, thiab lub luag haujlwm ntawmmob raumraws li tus kab mob sib kis thiab ua rau lwm tus mob NCDs. Cov ntaub ntawv dawb suav nrog cov ntawv pom zoo thiab cov kev tshuaj xyuas los ntawm cov kws tshaj lij hauv ntiaj teb tuaj yeem pab txhim kho cov hom phiaj no.36

Increasing education and awareness about renal diseases in general and kidney disease in childhood is very important


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