nach oben

Pediatric Nephrology

Erschienen in:

17.06.2017 | Review

Emerging biomarkers of chronic kidney disease in children

verfasst von: Jason H. Greenberg, Aadil Kakajiwala, Chirag R. Parikh, Susan Furth

Erschienen in: Pediatric Nephrology | Ausgabe 6/2018

Einloggen, um Zugang zu erhalten

Abstract

Chronic kidney disease (CKD) has become a significant public health concern, as it is associated with substantial morbidity. Prior research has evaluated multiple novel CKD biomarkers to supplement serum creatinine and proteinuria. The ultimate goal of this research is to find biomarkers that can be used to accurately predict CKD progression and to better time outpatient follow-up, and referral for transplant. Also, an optimal panel of biomarkers can augment the predictive value of proteinuria and serum creatinine by enriching patient enrollment in clinical trials. In this review, we discuss salient findings on 12 candidate plasma and urine biomarkers and their reported association with CKD. We explore the common pathways of CKD progression and the pathophysiologic processes of tubulointerstitial injury, inflammation, repair, and fibrosis that are potentially classified by specific biomarkers. We describe both pediatric and adult findings and highlight the paucity of pediatric research in CKD progression. It will be important for cohorts with longitudinal follow-up to evaluate these CKD biomarkers for potential use in pediatric clinical trials and routine CKD management.

(2002) KDOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification. NKF KDOQI Guidelines. National Kidney Foundation

Collins AJ, Foley RN, Chavers B, Gilbertson D, Herzog C, Johansen K, Kasiske B, Kutner N, Liu J, St Peter W, Guo H, Gustafson S, Heubner B, Lamb K, Li S, Li S, Peng Y, Qiu Y, Roberts T, Skeans M, Snyder J, Solid C, Thompson B, Wang C, Weinhandl E, Zaun D, Arko C, Chen SC, Daniels F, Ebben J, Frazier E, Hanzlik C, Johnson R, Sheets D, Wang X, Forrest B, Constantini E, Everson S, Eggers P, Agodoa L (2012) United States renal data system 2011 annual data report: atlas of chronic kidney disease & end-stage renal disease in the United States. Am J Kidney Dis 59(A7):e1–420

Group ET, Wuhl E, Trivelli A, Picca S, Litwin M, Peco-Antic A, Zurowska A, Testa S, Jankauskiene A, Emre S, Caldas-Afonso A, Anarat A, Niaudet P, Mir S, Bakkaloglu A, Enke B, Montini G, Wingen AM, Sallay P, Jeck N, Berg U, Caliskan S, Wygoda S, Hohbach-Hohenfellner K, Dusek J, Urasinski T, Arbeiter K, Neuhaus T, Gellermann J, Drozdz D, Fischbach M, Moller K, Wigger M, Peruzzi L, Mehls O, Schaefer F (2009) Strict blood-pressure control and progression of renal failure in children. N Engl J Med 361:1639–1650CrossRef

Levey AS, Cattran D, Friedman A, Miller WG, Sedor J, Tuttle K, Kasiske B, Hostetter T (2009) Proteinuria as a surrogate outcome in CKD: report of a scientific workshop sponsored by the National Kidney Foundation and the US Food and Drug Administration. Am J Kidney Dis 54:205–226CrossRefPubMed

Parikh CR, Lu JC, Coca SG, Devarajan P (2010) Tubular proteinuria in acute kidney injury: a critical evaluation of current status and future promise. Ann Clin Biochem 47:301–312CrossRefPubMed

Munoz A, Townsend K (2015) Use of generalized gamma regression models to assess explained variance of decline in GFR by UPCr and SCr. Johns Hopkins Bloomberg School of Public Health, p 7

Devarajan P (2010) The use of targeted biomarkers for chronic kidney disease. Adv Chronic Kidney Dis 17:469–479CrossRefPubMedPubMedCentral

Biomarkers Definitions Working G (2001) Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther 69:89–95CrossRef

(2016) BEST (Biomarkers, EndpointS, and other Tools) Resource, Maryland

10.

Schnaper HW (2014) Remnant nephron physiology and the progression of chronic kidney disease. Pediatr Nephrol 29:193–202CrossRefPubMed

11.

Avner ED, Harmon WE, Niaudet P, Yoshikawa N (2009) Pediatric nephrology. Williams & Wilkins, BaltimoreCrossRef

12.

Brenner BM, Chertow GM (1994) Congenital oligonephropathy and the etiology of adult hypertension and progressive renal injury. Am J Kidney Dis 23(2):171–175

13.

Brenner BM, Lawler EV, Mackenzie HS (1996) The hyperfiltration theory: a paradigm shift in nephrology. Kidney Int 49:1774–1777CrossRefPubMed

14.

Fogo AB (2007) Mechanisms of progression of chronic kidney disease. Pediatr Nephrol 22:2011–2022CrossRefPubMedPubMedCentral

15.

Brunner HI, Mueller M, Rutherford C, Passo MH, Witte D, Grom A, Mishra J, Devarajan P (2006) Urinary neutrophil gelatinase-associated lipocalin as a biomarker of nephritis in childhood-onset systemic lupus erythematosus. Arthritis Rheum 54:2577–2584CrossRefPubMed

16.

Trachtman H, Christen E, Cnaan A, Patrick J, Mai V, Mishra J, Jain A, Bullington N, Devarajan P, Investigators of the HUSSPMCT (2006) Urinary neutrophil gelatinase-associated lipocalin in D+HUS: a novel marker of renal injury. Pediatr Nephrol 21:989–994CrossRefPubMed

17.

Zubowska M, Wyka K, Fendler W, Mlynarski W, Zalewska-Szewczyk B (2013) Interleukin 18 as a marker of chronic nephropathy in children after anticancer treatment. Dis Markers 35:811–818CrossRefPubMedPubMedCentral

18.

Bienias B, Zajaczkowska M, Borzecka H, Sikora P, Wieczorkiewicz-Plaza A, Wilczynska B (2015) Early markers of tubulointerstitial fibrosis in children with idiopathic nephrotic syndrome: preliminary report. Medicine 94:e1746CrossRefPubMedPubMedCentral

19.

Ucakturk A, Avci B, Genc G, Ozkaya O, Aydin M (2016) Kidney injury molecule-1 and neutrophil gelatinase associated lipocalin in normoalbuminuric diabetic children. J Pediatr Endocrinol Metab 29:145–151CrossRefPubMed

20.

Tsau Y, Chen C (1999) Urinary epidermal growth factor excretion in children with chronic renal failure. Am J Nephrol 19:400–404CrossRefPubMed

21.

Korzeniecka-Kozerska A, Wasilewska A, Tenderenda E, Sulik A, Cybulski K (2013) Urinary MMP-9/NGAL ratio as a potential marker of FSGS in nephrotic children. Dis Markers 34:357–362CrossRefPubMedPubMedCentral

22.

Musial K, Zwolinska D (2011) Matrix metalloproteinases (MMP-2,9) and their tissue inhibitors (TIMP-1,2) as novel markers of stress response and atherogenesis in children with chronic kidney disease (CKD) on conservative treatment. Cell Stress Chaperones 16:97–103CrossRefPubMed

23.

Jianguo W, Zhenzhen L, Xianghua L, Zhanzheng Z, Suke S, Suyun W (2014) Serum and urinary procollagen III aminoterminal propeptide as a biomarker of obstructive nephropathy in children. Clin Chim Acta 434:29–33CrossRefPubMed

24.

Vianna HR, Soares CM, Silveira KD, Elmiro GS, Mendes PM, de Sousa TM, Teixeira MM, Miranda DM, Simoes ESAC (2013) Cytokines in chronic kidney disease: potential link of MCP-1 and dyslipidemia in glomerular diseases. Pediatr Nephrol 28:463–469CrossRefPubMed

25.

Ghobrial EE, El Hamshary AA, Mohamed AG, Abd El Raheim YA, Talaat AA (2015) Urinary monocyte chemoattractant protein-1 as a biomarker of lupus nephritis activity in children. Saudi J Kidney Dis Transpl 26:507–515CrossRefPubMed

26.

Woroniecki RP, Shatat IF, Supe K, Du Z, Kaskel FJ (2008) Urinary cytokines and steroid responsiveness in idiopathic nephrotic syndrome of childhood. Am J Nephrol 28:83–90CrossRefPubMed

27.

Zieg J, Blahova K, Seeman T, Bronsky J, Dvorakova H, Pechova M, Janda J, Matousovic K (2011) Urinary transforming growth factor-beta1 in children with obstructive uropathy. Nephrology 16:595–598CrossRefPubMed

28.

Musial K, Fornalczyk K, Zwolinska D (2008) Osteopontin (OPN), PDGF-BB (platelet-derived growth factor) and BMP-7 (bone morphogenetic protein) as markers of atherogenesis in children with chronic kidney disease (CKD) treated conservatively—preliminary results. Pol Merkur Lekarski 24(Suppl 4):25–27PubMed

29.

Jutley RS, Youngson GG, Eremin O, Ninan GK (2000) Serum cytokine profile in reflux nephropathy. Pediatr Surg Int 16:64–68CrossRefPubMed

30.

Wei C, Trachtman H, Li J, Dong C, Friedman AL, Gassman JJ, McMahan JL, Radeva M, Heil KM, Trautmann A, Anarat A, Emre S, Ghiggeri GM, Ozaltin F, Haffner D, Gipson DS, Kaskel F, Fischer DC, Schaefer F, Reiser J, PodoNet CFCS (2012) Circulating suPAR in two cohorts of primary FSGS. J Am Soc Nephrol 23:2051–2059CrossRefPubMedPubMedCentral

31.

Gellermann J, Schaefer F, Querfeld U (2014) Serum suPAR levels are modulated by immunosuppressive therapy of minimal change nephrotic syndrome. Pediatr Nephrol 29:2411–2414CrossRefPubMed

32.

Remuzzi G, Bertani T (1998) Pathophysiology of progressive nephropathies. N Engl J Med 339:1448–1456CrossRefPubMed

33.

Harris DC (2001) Tubulointerstitial renal disease. Curr Opin Nephrol Hypertens 10:303–313CrossRefPubMed

34.

Smith ER, Lee D, Cai MM, Tomlinson LA, Ford ML, McMahon LP, Holt SG (2013) Urinary neutrophil gelatinase-associated lipocalin may aid prediction of renal decline in patients with non-proteinuric stages 3 and 4 chronic kidney disease (CKD). Nephrol Dial Transplant 28:1569–1579CrossRefPubMed

35.

Gohda T, Niewczas MA, Ficociello LH, Walker WH, Skupien J, Rosetti F, Cullere X, Johnson AC, Crabtree G, Smiles AM, Mayadas TN, Warram JH, Krolewski AS (2012) Circulating TNF receptors 1 and 2 predict stage 3 CKD in type 1 diabetes. J Am Soc Nephrol 23:516–524CrossRefPubMedPubMedCentral

36.

Liu KD, Yang W, Anderson AH, Feldman HI, Demirjian S, Hamano T, He J, Lash J, Lustigova E, Rosas SE, Simonson MS, Tao K, Hsu CY, Chronic Renal Insufficiency Cohort study investigators (2013) Urine neutrophil gelatinase-associated lipocalin levels do not improve risk prediction of progressive chronic kidney disease. Kidney Int 83:909–914CrossRefPubMedPubMedCentral

37.

Zappitelli M, Washburn KK, Arikan AA, Loftis L, Ma Q, Devarajan P, Parikh CR, Goldstein SL (2007) Urine neutrophil gelatinase-associated lipocalin is an early marker of acute kidney injury in critically ill children: a prospective cohort study. Crit Care 11:R84CrossRefPubMedPubMedCentral

38.

Kasahara M, Mori K, Satoh N, Kuwabara T, Yokoi H, Shimatsu A, Sugawara A, Mukoyama M, Nakao K (2009) Reduction in urinary excretion of neutrophil gelatinase-associated lipocalin by angiotensin receptor blockers in hypertensive patients. Nephrol Dial Transplant 24:2608–2609 author reply 2609-2610 CrossRefPubMedPubMedCentral

39.

Kuwabara T, Mori K, Mukoyama M, Kasahara M, Yokoi H, Saito Y, Yoshioka T, Ogawa Y, Imamaki H, Kusakabe T, Ebihara K, Omata M, Satoh N, Sugawara A, Barasch J, Nakao K (2009) Urinary neutrophil gelatinase-associated lipocalin levels reflect damage to glomeruli, proximal tubules, and distal nephrons. Kidney Int 75:285–294CrossRefPubMed

40.

Hall IE, Doshi MD, Reese PP, Marcus RJ, Thiessen-Philbrook H, Parikh CR (2012) Association between peritransplant kidney injury biomarkers and 1-year allograft outcomes. Clin J Am Soc Nephrol 7:1224–1233CrossRefPubMedPubMedCentral

41.

Shlipak MG, Scherzer R, Abraham A, Tien PC, Grunfeld C, Peralta CA, Devarajan P, Bennett M, Butch AW, Anastos K, Cohen MH, Nowicki M, Sharma A, Young MA, Sarnak MJ, Parikh CR (2012) Urinary markers of kidney injury and kidney function decline in HIV-infected women: biomarkers and kidney decline. J Acquir Immune Defic Syndr 61:565–573CrossRefPubMedPubMedCentral

42.

Peralta C, Scherzer R, Grunfeld C, Abraham A, Tien P, Devarajan P, Bennett M, Butch A, Anastos K, Cohen M, Nowicki M, Sharma A, Young M, Sarnak M, Parikh C, Shlipak M (2014) Urinary biomarkers of kidney injury are associated with all-cause mortality in the Women’s interagency HIV study (WIHS). HIV Med 15:291–300CrossRefPubMed

43.

Parikh CR, Thiessen-Philbrook H, Garg AX, Kadiyala D, Shlipak MG, Koyner JL, Edelstein CL, Devarajan P, Patel UD, Zappitelli M, Krawczeski CD, Passik CS, Coca SG, Consortium T-A (2013) Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of AKI after cardiac surgery. Clin J Am Soc Nephrol 8:1079–1088CrossRefPubMedPubMedCentral

44.

van Timmeren MM, van den Heuvel MC, Bailly V, Bakker SJ, van Goor H, Stegeman CA (2007) Tubular kidney injury molecule-1 (KIM-1) in human renal disease. J Pathol 212:209–217CrossRefPubMed

45.

van Timmeren MM, Vaidya VS, van Ree RM, Oterdoom LH, de Vries AP, Gans RO, van Goor H, Stegeman CA, Bonventre JV, Bakker SJ (2007) High urinary excretion of kidney injury molecule-1 is an independent predictor of graft loss in renal transplant recipients. Transplantation 84:1625–1630CrossRefPubMedPubMedCentral

46.

Szeto CC, Kwan BC, Lai KB, Lai FM, Chow KM, Wang G, Luk CC, Li PK (2010) Urinary expression of kidney injury markers in renal transplant recipients. Clin J Am Soc Nephrol 5:2329–2337CrossRefPubMedPubMedCentral

47.

Sabbisetti VS, Waikar SS, Antoine DJ, Smiles A, Wang C, Ravisankar A, Ito K, Sharma S, Ramadesikan S, Lee M, Briskin R, De Jager PL, Ngo TT, Radlinski M, Dear JW, Park KB, Betensky R, Krolewski AS, Bonventre JV (2014) Blood kidney injury molecule-1 is a biomarker of acute and chronic kidney injury and predicts progression to ESRD in type I diabetes. J Am Soc Nephrol 25:2177–2186CrossRefPubMedPubMedCentral

48.

Ju W, Nair V, Smith S, Zhu L, Shedden K, Song PX, Mariani LH, Eichinger FH, Berthier CC, Randolph A, Lai JY, Zhou Y, Hawkins JJ, Bitzer M, Sampson MG, Thier M, Solier C, Duran-Pacheco GC, Duchateau-Nguyen G, Essioux L, Schott B, Formentini I, Magnone MC, Bobadilla M, Cohen CD, Bagnasco SM, Barisoni L, Lv J, Zhang H, Wang HY, Brosius FC, Gadegbeku CA, Kretzler M, Ercb CPN, Consortium PK-I (2015) Tissue transcriptome-driven identification of epidermal growth factor as a chronic kidney disease biomarker. Sci Transl Med 7:316ra193CrossRefPubMedPubMedCentral

49.

Cheng S, Pollock AS, Mahimkar R, Olson JL, Lovett DH (2006) Matrix metalloproteinase 2 and basement membrane integrity: a unifying mechanism for progressive renal injury. FASEB J 20:1898–1900CrossRefPubMed

50.

Hsu TW, Kuo KL, Hung SC, Huang PH, Chen JW, Tarng DC (2013) Progression of kidney disease in non-diabetic patients with coronary artery disease: predictive role of circulating matrix metalloproteinase-2, −3, and −9. PLoS One 8:e70132CrossRefPubMedPubMedCentral

51.

Wong MG, Perkovic V, Woodward M, Chalmers J, Li Q, Hillis GS, Yaghobian Azari D, Jun M, Poulter N, Hamet P, Williams B, Neal B, Mancia G, Cooper M, Pollock CA (2013) Circulating bone morphogenetic protein-7 and transforming growth factor-beta1 are better predictors of renal end points in patients with type 2 diabetes mellitus. Kidney Int 83:278–284CrossRefPubMed

52.

Zeisberg M, Hanai J, Sugimoto H, Mammoto T, Charytan D, Strutz F, Kalluri R (2003) BMP-7 counteracts TGF-beta1-induced epithelial-to-mesenchymal transition and reverses chronic renal injury. Nat Med 9:964–968CrossRefPubMed

53.

Hruska KA, Guo G, Wozniak M, Martin D, Miller S, Liapis H, Loveday K, Klahr S, Sampath TK, Morrissey J (2000) Osteogenic protein-1 prevents renal fibrogenesis associated with ureteral obstruction. Am J Physiol Ren Physiol 279:F130–F143CrossRef

54.

Schwartz GJ, Munoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, Furth SL (2009) New equations to estimate GFR in children with CKD. J Am Soc Nephrol 20:629–637CrossRefPubMedPubMedCentral

55.

Ghoul BE, Squalli T, Servais A, Elie C, Meas-Yedid V, Trivint C, Vanmassenhove J, Grunfeld JP, Olivo-Marin JC, Thervet E, Noel LH, Prie D, Fakhouri F (2010) Urinary procollagen III aminoterminal propeptide (PIIINP): a fibrotest for the nephrologist. Clin Am Soc Nephrol 5:205–210CrossRef

56.

Teppo AM, Tornroth T, Honkanen E, Gronhagen-Riska C (2003) Urinary amino-terminal propeptide of type III procollagen (PIIINP) as a marker of interstitial fibrosis in renal transplant recipients. Transplantation 75:2113–2119CrossRefPubMed

57.

Ix JH, Biggs ML, Mukamal K, Djousse L, Siscovick D, Tracy R, Katz R, Delaney JA, Chaves P, Rifkin DE, Hughes-Austin JM, Garimella PS, Sarnak MJ, Shlipak MG, Kizer JR (2015) Urine collagen fragments and CKD progression-the cardiovascular health study. J Am Soc Nephrol 26:2494–2503CrossRefPubMedPubMedCentral

58.

Niewczas MA, Gohda T, Skupien J, Smiles AM, Walker WH, Rosetti F, Cullere X, Eckfeldt JH, Doria A, Mayadas TN, Warram JH, Krolewski AS (2012) Circulating TNF receptors 1 and 2 predict ESRD in type 2 diabetes. J Am Soc Nephrol 23:507–515CrossRefPubMedPubMedCentral

59.

Hayek SS, Sever S, Ko YA, Trachtman H, Awad M, Wadhwani S, Altintas MM, Wei C, Hotton AL, French AL, Sperling LS, Lerakis S, Quyyumi AA, Reiser J (2015) Soluble urokinase receptor and chronic kidney disease. New Engl J Med 373:1916–1925CrossRefPubMedPubMedCentral

60.

Al-Lamki RS, Mayadas TN (2015) TNF receptors: signaling pathways and contribution to renal dysfunction. Kidney Int 87:281–296CrossRefPubMed

61.

Bitzan M, Babayeva S, Vasudevan A, Goodyer P, Torban E (2012) TNFalpha pathway blockade ameliorates toxic effects of FSGS plasma on podocyte cytoskeleton and beta3 integrin activation. Pediatr Nephrol 27:2217–2226CrossRefPubMed

62.

Ernandez T, Mayadas TN (2009) Immunoregulatory role of TNFalpha in inflammatory kidney diseases. Kidney Int 76:262–276CrossRefPubMed

63.

Shankar A, Sun L, Klein BE, Lee KE, Muntner P, Nieto FJ, Tsai MY, Cruickshanks KJ, Schubert CR, Brazy PC, Coresh J, Klein R (2011) Markers of inflammation predict the long-term risk of developing chronic kidney disease: a population-based cohort study. Kidney Int 80:1231–1238CrossRefPubMedPubMedCentral

64.

Dounousi E, Koliousi E, Papagianni A, Ioannou K, Zikou X, Katopodis K, Kelesidis A, Tsakiris D, Siamopoulos KC (2012) Mononuclear leukocyte apoptosis and inflammatory markers in patients with chronic kidney disease. Am J Nephrol 36:531–536CrossRefPubMed

65.

Misaki T, Yamamoto T, Suzuki S, Fukasawa H, Togawa A, Ohashi N, Suzuki H, Fujigaki Y, Oda T, Uchida C, Kitagawa K, Hattori T, Kitagawa M, Hishida A (2009) Decrease in tumor necrosis factor-alpha receptor-associated death domain results from ubiquitin-dependent degradation in obstructive renal injury in rats. Am J Pathol 175:74–83CrossRefPubMedPubMedCentral

66.

Guo G, Morrissey J, McCracken R, Tolley T, Klahr S (1999) Role of TNFR1 and TNFR2 receptors in tubulointerstitial fibrosis of obstructive nephropathy. Am J Phys 277:F766–F772CrossRef

67.

Hasegawa H, Kohno M, Sasaki M, Inoue A, Ito MR, Terada M, Hieshima K, Maruyama H, Miyazaki J, Yoshie O, Nose M, Fujita S (2003) Antagonist of monocyte chemoattractant protein 1 ameliorates the initiation and progression of lupus nephritis and renal vasculitis in MRL/lpr mice. Arthritis Rheum 48:2555–2566CrossRefPubMed

68.

Tesch GH (2008) MCP-1/CCL2: a new diagnostic marker and therapeutic target for progressive renal injury in diabetic nephropathy. Am J Physiol Ren Physiol 294:F697–F701CrossRef

69.

Nadkarni GN, Rao V, Ismail-Beigi F, Fonseca VA, Shah SV, Simonson MS, Cantley L, Devarajan P, Parikh CR, Coca SG (2016) Association of urinary biomarkers of inflammation, injury, and fibrosis with renal function decline: the ACCORD trial. Clin J Am Soc Nephrol 11:1343–1352CrossRefPubMedPubMedCentral

70.

Camilla R, Brachemi S, Pichette V, Cartier P, Laforest-Renald A, MacRae T, Madore F, Troyanov S (2011) Urinary monocyte chemotactic protein 1: marker of renal function decline in diabetic and nondiabetic proteinuric renal disease. J Nephrol 24:60–67CrossRefPubMed

71.

de Zeeuw D, Bekker P, Henkel E, Hasslacher C, Gouni-Berthold I, Mehling H, Potarca A, Tesar V, Heerspink HJ, Schall TJ, Group CBDNS (2015) The effect of CCR2 inhibitor CCX140-B on residual albuminuria in patients with type 2 diabetes and nephropathy: a randomised trial. Lancet Diabetes Endocrinol 3:687–696CrossRefPubMed

72.

Breyer MD, Susztak K (2016) The next generation of therapeutics for chronic kidney disease. Nat Rev Drug Discov 15:568–588CrossRefPubMedPubMedCentral

Titel: Emerging biomarkers of chronic kidney disease in children
verfasst von: Jason H. Greenberg
Aadil Kakajiwala
Chirag R. Parikh
Susan Furth
Publikationsdatum: 17.06.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 6/2018
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-017-3701-9

Neu im Fachgebiet Pädiatrie

23.04.2024 | Typ-1-Diabetes | Nachrichten

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Emerging biomarkers of chronic kidney disease in children

Abstract

Neu im Fachgebiet Pädiatrie

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Update Pädiatrie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2018

Nephrotic-range proteinuria and brown urine in an 8-year-old girl: Questions

Extra uterine development of preterm kidneys

Outcome of renal transplantation in small infants: a match-controlled analysis

A curious case of growth failure and hypercalcemia: Questions

Amniotic fluid cells: current progress and emerging challenges in renal regeneration

Hyperchloremia is independently associated with mortality in critically ill children who ultimately require continuous renal replacement therapy

Neu im Fachgebiet Pädiatrie

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Update Pädiatrie