Glomerular Filtration Rate Reference Values in Very Preterm Infants

Vieux, Rachel; Hascoët, Jean‐Michel; Merdariu, Dana; Fresson, Jeanne; Guillemin, Françis

doi:10.1542/peds.2009-1426

Cited by 140 publications

(85 citation statements)

References 26 publications

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“…All investigators remained strictly blinded to this allocation in order not to prejudice any aspect of long-term follow-up examination. As to the renal development and functional adaptation of the kidneys [14,15,16], patients were allocated to two groups according to their gestational age at birth: group 1: 26 0/7–28 6/7 weeks (rEpo n = 21; placebo n = 14); group 2: 29 0/7–31 6/7 (rEpo n = 21; placebo n = 19). For statistical analysis, the Mann-Whitney U test (two-sided) or the ANOVA were applied as indicated.…”

Section: Methodsmentioning

confidence: 99%

Urinary Erythropoietin Concentrations after Early Short-Term Infusion of High-Dose Recombinant Epo for Neuroprotection in Preterm Neonates

et al. 2012

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Background: High-dose recombinant human erythropoietin (rEpo) has first been administered in clinical trials for neuroprotection in very preterm neonates at high risk of brain injury and in (near-) term neonates with hypoxic-ischemic encephalopathy. However, recent trials in adults raised concerns about the safety of high-dose rEpo for neuro- and cardioprotection. Objectives: To evaluate the putative accumulation or renal leakage of Epo as a function of developmental stage after repetitive early short-term infusion of high-dose rEpo (3 × 3,000 U/kg within 42 h after birth; NCT00413946) for neuroprotection in very preterm infants. Methods: Epo concentrations were measured using the ELISA technique in the first two consecutive urine specimens after each rEpo infusion. Results: Renal Epo excretion was significantly higher in preterm infants with gestational ages <29 weeks than in more mature infants and reached up to 23% of the administered rEpo within 8 h after each infusion. The urinary Epo concentration did not increase after three repetitive infusions of high-dose rEpo. The ratio of urinary Epo to total protein concentrations was the same in infants with gestational ages <29 weeks and in those with gestational ages ≥29 weeks. Conclusions: Our data suggest that the higher renal Epo excretion in more immature infants may be attributed to a higher glomerular filtration leakage due to the lower maturation of the kidneys and argue against saturation kinetics after multiple doses of 3,000 U/kg rEpo. This information should be considered in future trials on the use of rEpo for neuroprotection in neonates.

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Section: Methodsmentioning

confidence: 99%

Urinary Erythropoietin Concentrations after Early Short-Term Infusion of High-Dose Recombinant Epo for Neuroprotection in Preterm Neonates

et al. 2012

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“…and 1.5-2.5 kg), the first two groups were combined and a GA of 30 weeks assumed on the basis of the demographic data of Cole et al (2014). Again a newborn population 0-0.0027y was used in the simulations with a reduction of 40% in the renal clearance of digoxin applied to correct for the lower GFR in this group on the basis of the data from Vieux et al (2010). Ten trials of six subjects, proportion of females 0.5, were run and the mean observed and predicted CL (l/kg per hour) were compared assuming 5, 10, 20, and 50% of adult biliary elimination.…”

Section: Pediatric Pbpk Modelingmentioning

confidence: 99%

How Does In Vivo Biliary Elimination of Drugs Change with Age? Evidence from In Vitro and Clinical Data Using a Systems Pharmacology Approach

Johnson

Jamei

Rowland‐Yeo

2016

Drug Metabolism and Disposition

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Information on the developmental changes in biliary excretion (BE) of drugs is sparse. The aims of this study were to collate literature data on the pharmacokinetics of biliary excretion of drugs used in pediatrics and to apply a physiologically based pharmacokinetic (PBPK) model to predict their systemic clearance (CL) with a view to elucidating age-related changes in biliary excretion. Drug parameters for azithromycin, ceftriaxone, and digoxin administered intravenously and buprenorphine (intravenous and sublingual) were collated from the literature and used in the Simcyp Simulator to predict adult CL values, which were then validated against observed data. The change in CL with age was simulated in the pediatric model and compared with observed data; where necessary, the ontogeny function associated with BE was applied to recover the age-related CL. For azithromycin a fraction of adult BE activity of 15% was necessary to predict the CL in neonates (26 weeks gestational age) and 100% activity was apparent by 7 months. For ceftriaxone and digoxin full BE activity appeared to be present at term birth; for digoxin, an adult BE activity of 10% was needed to predict the CL in premature neonates (30 weeks gestational age). The CL of buprenorphine with age was described by the ontogeny of the major elimination pathways (CYP3A4 and UGT1A1) with no ontogeny assumed for the biliary component. Thus, the ontogeny of BE for all four drugs appears to be rapid and they attain adult levels at birth or within the first few months of postnatal age.

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“…This dysfunction causes abnormal regulation of bodily fluids and electrolytes. It occurs as a rapid decrease in glomerular filtration rate (GER) that leads to retention of the creatinine and the nitrogenous waste products and usually with a decrease in the urine output [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Acute Kidney Injury in Newborns

Timovska

Cekovska

Tosheska-Trajkovska

2015

Prilozi

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Objective: Acute kidney injury is common condition in the neonatal intensive care unit and it is associated with poor outcome. The incidence of neonatal AKI is the highest one followed by adults and children, depending on different factors such as the gestational age, birth weight, contributing conditions and the facilities of the neonatal intensive care unit. The aim of the study was to determine the incidence, risk factors and the outcome of the neonatal acute kidney injury. Subjects and Methods: This was a clinical, prospective study that was performed in a referent NICU at the University Children's Hospital in Skopje. All neonates admitted from January 2012 to December 20014 with documented acute kidney injury were included. The medical data records of the admitted neonates with AKI were analyzed. The material was statistically processed using methods of the descriptive statistics. Results: During the study period 770 newborn infants were admitted to the NICU and 50 (6.5%) infants developed acute kidney injury. The male to female ratio was 2.1:1. Most of the neonates involved in the study were neonates born at term (62%). Oliguric AKI was found in 28 cases (56%) and no oliguric in 22 cases (44%). The prevalence of prerenal, renal and post renal AKI were 78.5%, 19.5% and 2.0% respectively. Perinatal asphyxia was the most common predisposing factor for AKI and was evaluated in 38% of the cases with predominance of term infants and male. The mortality rate was 32% and was significantly higher in the group of patients with congenital heart diseases. Conclusion: AKI is a life threatening condition with still high mortality rate. Early recognition of the risk factors and the rapid effective treatment of the contributing conditions will reduce AKI in the neonatal period.

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Glomerular Filtration Rate Reference Values in Very Preterm Infants

Cited by 140 publications

References 26 publications

Urinary Erythropoietin Concentrations after Early Short-Term Infusion of High-Dose Recombinant Epo for Neuroprotection in Preterm Neonates

Urinary Erythropoietin Concentrations after Early Short-Term Infusion of High-Dose Recombinant Epo for Neuroprotection in Preterm Neonates

How Does In Vivo Biliary Elimination of Drugs Change with Age? Evidence from In Vitro and Clinical Data Using a Systems Pharmacology Approach

Acute Kidney Injury in Newborns

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