Клинические рекомендации по лечению детей c мочекаменной болезнью, разработанные Международным альянсом мочекаменной болезни

Целью данного исследования являлась разработка шестых рекомендаций из серии Международного альянса по мочекаменной болезни (International Alliance of Urolithiasis, IAU), посвящённых лечению детей с мочекаменной болезнью (МКБ) на основании данных наивысшего уровня доказательности. Все рекомендации были сформулированы на основе систематического обзора и анализа литературы, опубликованной в базе данных PubMed за период с января 1952 года по декабрь 2023 года. Оценка силы рекомендаций проводилась с использованием модифицированной методологии GRADE. Каждая рекомендация утверждалась членами рабочей группы IAU после анализа и обсуждения представленных доказательств. В результате разработаны рекомендации по следующим ключевым аспектам: этиология, факторы риска, клинические проявления и симптомы, диагностика, консервативное лечение, хирургические вмешательства, профилактика и наблюдение. Отмечается определённое сходство в подходах к лечению первичного эпизода МКБ у взрослых и детей, включая как стратегию консервативной терапии, так и внедрение современных малоинвазивных технологий для удаления камней. Кроме того, профилактические стратегии, направленные на снижение риска рецидива, такие как адекватное потребление жидкости, сбалансированное питание и индивидуализированная лекарственная терапия, имеют высокую эффективность у детей с МКБ. В зависимости от выраженности метаболических нарушений и наличия анатомических аномалий каждому пациенту должна быть назначена индивидуализированная программа наблюдения, направленная на минимизацию риска повторного образования конкрементов.

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