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DOI: 10.1055/s-2008-1027533
© Georg Thieme Verlag KG Stuttgart · New York
Nierenbeteiligung beim systemischen Lupus erythematodes im Kindes- und Jugendalter
Renal Involvement in Children and Adolescents with Systemic Lupus ErythematosusPublikationsverlauf
Publikationsdatum:
03. Juli 2008 (online)

Zusammenfassung
Der Nierenbeteiligung kommt bei Kindern und Jugendlichen mit systemischen Lupus erythematodes (SLE) bezüglich der langfristigen Morbidität und Mortalität die entscheidende Rolle zu. Insbesondere können Patienten mit diffus-proliferativer Lupusnephritis selbst bei relativ blander Klinik eine irreversible Nierenschädigung mit progredienter Niereninsuffzienz aufweisen. Daher sind eine frühzeitige Diagnosestellung und Einleitung einer entsprechenden immunsuppressiven und antihypertensiven Therapie der Lupusnephritis unabdingbar. Darüber hinaus muss die Therapie in diesem Lebensalter auch entwicklungsstadiumsspezifische (Wachstum, Pubertät, Reifung der Gonaden) und psychologische (Non-Compliance) Aspekte berücksichtigen. Eine optimale Betreuung der SLE-Patienten ist nur in enger interdisziplinärer Zusammenarbeit zwischen pädiatrischen Rheumatologen und Nephrologen möglich.
Abstract
In children and adolescents with systemic lupus erythematosus (SLE) the assessment of renal involvement is of special importance with respect to long-term morbidity and mortality. In particular, patients presenting with diffuse-proliferative lupus nephritis may develop irreversible progressive renal failure in spite of rather mild clinical symptoms at initial presentation. Therefore, early diagnosis and appropriate immunosuppressive and antihypertensive treatment of lupus nephritis are mandatory. Pharmacological treatment in this age group must also place emphasis on the specific problems of growth and development (longitudinal growth, puberty, gonadal function) as well as on psychological issues (non-compliance). Thus, close cooperation between paediatric rheumatologists and nephrologists is mandatory to provide optimal care for children with SLE.
Schlüsselwörter
systemischer Lupus erythematodes - Lupusnephritis - Proteinurie - Nierenversagen - Nierenbiopsie
Key words
systemic lupus erythematosus - lupus nephritis - proteinuria - renal failure - renal biopsy
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Prof. Dr. Dieter Haffner
Abteilung für Allgemeine Pädiatrie mit Nephrologie, Onkologie und Neonatologie, Universitäts-Kinder-
und Jugendklinik
Rembrandtstr. 16 / 17
18055 Rostock
Telefon: ++ 49/3 81/4 94 70 01
Fax: ++ 49/3 81/4 94 70 02
eMail: dieter.haffner@med.uni-rostock.de