Update akutes Nierenversagen bei Kindern

ZUSAMMENFASSUNG

Akutes Nierenversagen (ANV) bei Kindern zeichnet sich durch eine abrupte, potenziell reversible Abnahme der globalen Nierenfunktion aus. Das ANV ist eine häufige Erkrankung, die in bis zu 30 % der intensivmedizinisch betreuten Kinder auftritt. Die Etablierung von standardisierten Klassifikationssystemen (pRIFLE, AKIN, KDIGO) hat deutlich höhere ANV-Inzidenzen und Mortalitätsraten in pädiatrischen Patienten aufgezeigt. Da das Serumkreatinin erst ab einem Abfall der Nierenleistung auf 50 % auffällig wird, sind das Cystatin C – als von der Muskelmasse unabhängigerer Marker – und der Harnstoff basale Laborparameter. Zusätzlich sind die Urindiagnostik sowie eine Sonografie der Nieren essenziell für die Diagnosestellung. Die Therapie des ANVs ist rein supportiv, erfordert genaue Ursachenidentifikation und ist oft mit dem Einsatz von Nierenersatzverfahren verbunden. Die erste nephrologische Kontrolle nach durchgestandene ANV sollte nach spätestens 3 Monaten erfolgen. Bei schweren ANV-Verläufen sollte die Nachbetreuung durch einen/eine Kindernephrolog:in durchgeführt werden. Da ANV langfristige Folgen wie Proteinurie, arterielle Hypertonie und CNV mit sich bringen kann, ist ein lebenslanges Monitoring dieser Patienten essenziell.

Publication History

Article published online:
07 October 2024

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