scholarly journals Dose Estimation for Renal-excretion Drugs in Neonates and Infants Based on Physiological Development of Renal Function

2009 ◽  
Vol 129 (7) ◽  
pp. 829-842 ◽  
Author(s):  
Shinya SUZUKI ◽  
Yuka MURAYAMA ◽  
Erika SUGIYAMA ◽  
Masao SEKIYAMA ◽  
Hitoshi SATO
Keyword(s):  
Renal Function ◽  
Renal Excretion ◽  
Dose Estimation ◽  
Neonates And Infants

scholarly journals Outcome analysis of early surgery and conservative treatment in neonates and infants with severe hydronephrosis

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110578
Author(s):  
Qi-Fei Deng ◽  
Han Chu ◽  
Bo Peng ◽  
Xiang Liu ◽  
Yong-Sheng Cao
Keyword(s):  
Renal Function ◽  
Conservative Treatment ◽  
Ureteropelvic Junction Obstruction ◽  
Renal Cortex ◽  
Outcome Analysis ◽  
Neonates And Infants ◽  
Functional Indices ◽  
Early Surgical Treatment ◽  
Better Than

Objective The treatment strategy and timing of ureteropelvic junction obstruction (UPJO) in infants remain controversial. This study aimed to compare the effect of early surgical treatment (EST) and conservative treatment (CT) on neonates and infants with UPJO and their recovery of renal function and morphology. Methods Eighty neonates and infants with severe hydronephrosis were enrolled in this study. They received early pyeloureteroplasty or CT. Diethylenetriamine pentaacetate was used to assess renal function. Results There were no significant differences in renal function or renal indices at baseline between the two groups. At 3 and 6 months of follow-up, the anteroposterior diameter of the renal pelvis and the Society of Fetal Urology grade in the EST surgery group were significantly lower compared with those at baseline. The thickness of the renal cortex was greater in the EST group than in the CT group at 3 and 6 months of follow-up. After follow-up for 6 months, renal function in the EST group was significantly better than that in the CT group. Conclusion EST accelerates the recovery of renal morphological and functional indices in neonates and infants with severe hydronephrosis.

The Effects of Ginsenosides and Anserine on the Up-Regulation of Renal Aquaporins 1–4 in Hyperuricemic Mice

2019 ◽  
Vol 47 (05) ◽  
pp. 1133-1147
Author(s):  
Yalin Zhang ◽  
Han Su ◽  
Juan Zhang ◽  
Juan Kong
Keyword(s):  
Metabolic Disease ◽  
Renal Function ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Clearance Rate ◽  
Renal Excretion ◽  
Synergistic Effects ◽  
Acid Excretion ◽  
Urea Nitrogen ◽  
Uric Acid Excretion

Hyperuricemia is a metabolic disease of the kidney that results in decreased uric acid excretion. Here, we aimed to investigate the effects of ginsenosides and anserine on hyperuricemia and the expression of aquaporin (AQP) 1–4, which are indicators of renal excretion. Ginsenosides and anserine were administered separately or together after the establishment of hyperuricemia with adenine in BALB/c mice. Renal function indexes such as serum uric acid, creatinine, and urea nitrogen were measured in each group of mice, and the expression of AQP1–4 in renal tissues was detected. Serum uric acid and urea nitrogen were decreased in the ginsenoside and the anserine +UA groups. Meanwhile, the uric acid excretion and clearance rate were clearly increased in the co-treatment +UA group ([Formula: see text].05). Moreover, ginsenosides or anserine ginsenosides or anserine alone and treatment with both increased the expression of AQP1–4; however, the synergistic effects were more significantly enhanced ([Formula: see text].01). We provide the first reported evidence that ginsenosides and anserine have synergistic effects on uric acid excretion. The improvement in renal function in hyperuricemic mice after treatment with ginsenosides and anserine may result from up-regulation of AQP1–4 expressions.

scholarly journals MINIMALLY INVASIVE SURGERY FOR CONGENITAL HYDRONEPHROSIS IN CHILDREN

2016 ◽  
Vol 65 (3) ◽  
pp. 279-282
Author(s):  
Anna Kadar ◽  
◽  
Lorena Vatra ◽  
Marcel Oancea ◽  
◽  
...  
Keyword(s):  
Renal Function ◽  
Invasive Surgery ◽  
Significant Proportion ◽  
Minimal Invasive ◽  
Invasive Treatment ◽  
Colicky Pain ◽  
Tract Infections ◽  
Laparoscopic Techniques ◽  
Neonates And Infants ◽  
Parenchymal Thickness

Introduction. Minimal invasive treatment for congenital hydro nephrosis in children remains a controversial topic, both in defining the necessity and timing of operation using laparoscopic techniques in neonates and infants. Materials and methods. This study aims to analyze criteria used for surgery in a series of patients operated in a laparoscopic manner, for congenital hydro nephrosis, at the Emergency Clinical Hospital for Children “Marie Curie” Bucharest, Department of Pediatric Surgery, between 2007-2015. Results. In our series, the most frequent found criteria for surgery were anterior-posterior diameter over 3 cm, followed by 50% reduced parenchymal thickness, decreased renal function under 40% and finally symptomatic criteria – urinary tract infections and flank colicky pain. Both pelvic dilatation and parenchymal thickness correlates with renal function, though reduced parenchymal thickness has a stronger correlation. Infants under 1 year and under 10 kg represented a significant proportion (17.5% and 22.5% respectively). Conclusions. Young age (under 1 year old) and low-weight (under 10 kilos) in children are not reasons to delay classical or laparoscopic surgical treatment for PUJO (pyelo-ureteric junction obstruction). Pyelectasis is not specific to PUJO. It does not always mean obstruction and does not always show a strong correlation with impaired renal function. Best in establishing therapeutic conduct are the magnitude of renal parenchymal restructuring, the degree of renal function impairment and clinical symptomatology. Laparoscopic treatment is an effective surgical approach, that meets all the major advantages of minimal invasive surgery, applicable to infants and small children, regardless of age and weight.

scholarly journals Minimally invasive treatment of obstructions of the pyeloureteral segment in neonates and infants. State of the art

2020 ◽  
Vol 24 (5) ◽  
pp. 331-339
Author(s):  
Yury A. Kozlov ◽  
A. A. Rasputin ◽  
K. A. Kovalkov ◽  
P. Zh. Baradieva ◽  
Ch. B. Ochirov ◽  
...  
Keyword(s):  
Renal Function ◽  
Minimally Invasive ◽  
Complex Nature ◽  
Laparoscopic Pyeloplasty ◽  
High Definition ◽  
Invasive Treatment ◽  
Surgical Interventions ◽  
Reconstructive Operations ◽  
Wide Range ◽  
Neonates And Infants

Introduction. The obstruction of pyeloureteral junction is the most common cause of hydronephrosis in neonates and infants. Indications for surgical treatment include: decrease in differentiated renal function less than 40%, continued decrease in differentiated renal function for more than 10% in subsequent examinations, poor excretory function at diuretic renography (T ½ more than 20 min), increase in the anteroposterior diameter of the pelvis over 20 mm or dilatation of degrees III and IV by the classification of the Society of Fetal Urology (SFU). Material and methods. Treatment options for this condition include a wide range of approaches - from active observation to minimally invasive methods, including laparoscopic or robotic pyeloplasty. The main goal of treatment is to alleviate symptoms as well as to improve and / or to maintain renal function. The most common technique for removing obstruction of the pyeloureteral junction is dismembered pyeloplasty which is also called Anderson-Hynes operation. The Anderson-Hynes laparoscopic pyeloplasty is not widely spread what reflects the complex nature of this surgery in newborns and infants. A surgical access aiming to provide a minimally invasive correction of the obstruction in the pelvic-ureteric junction can be achieved equally by laparoscopic pyeloplasty, retroperitoneoscopicpyeloplasty and robot-assisted laparoscopic pyeloplasty. Results. Currently, there is a limited number of reports on the application of laparoscopic techniques for treating pyeloureteral segment obstructions in newborns and infants. The reasonability of such an approach in children under one year of age remains a matter of debate. It has been found out that postoperative results after laparoscopy are similar to those after a conventional open intervention. Conclusion. This literature review demonstrates that a surgeon - before performing reconstructive operations on infant’s kidneys must have a good experience in many other advanced laparoscopic procedures with endosurgical suturing . Laparoscopy offers many more benefits than simply reducing the patient’s hospital stay or less drug use. The magnification inherent to high-definition (HD) or ultra-high-resolution television (UHD or 4K) technology makes these surgical interventions more accurate due to better visualization of such microobjects and their layers at the baby’s ureter, which has a diameter slightly exceeding 2 mm. Another advantage of laparoscopy lies in more adequate assessment of the situation in case of hydronephrosis than that in the open surgery.

Pharmacokinetic considerations in pediatric pharmacotherapy

2019 ◽  
Vol 76 (19) ◽  
pp. 1472-1480 ◽  
Author(s):  
Sin Yin Lim ◽  
Rebecca S Pettit
Keyword(s):  
Renal Function ◽  
Young Children ◽  
Absorption Rate ◽  
Pediatric Population ◽  
Water Soluble ◽  
Pharmacokinetic Data ◽  
Older Children ◽  
Organ Systems ◽  
Water Soluble Drugs ◽  
Neonates And Infants

Abstract Purpose The changes in physiological functions as children grow and organ systems mature result in pharmacokinetic alterations throughout childhood. These alterations in children result in absorption, distribution, metabolism, and excretion of drugs that are different from those seen in the typical adult diseased population. Summary Changes in gastrointestinal motility and gastric pH in neonates and infants affect the absorption rate and bioavailability of drugs. Skin absorption rate and extent can be altered by different skin structures and perfusion in young children. Intramuscular and rectal absorption become less predictable in children due to erratic absorption site perfusion and other factors. Children’s body compositions also differ greatly from that in adults. Water-soluble drugs distribute more extensively in newborns due to larger water content than in older children and adults. Drug elimination and excretion are also affected in pediatric population due to differences in liver and renal function. Immature enzyme development and renal function result in reduced clearance of drugs in young children. There are limited pharmacokinetic data available for many drugs used in children. Conclusion Considering the changes in pharmacokinetics in children can help pharmacists optimize the dosing and monitoring of drugs and do the best they can to help this vulnerable population.

scholarly journals A minimal physiologically based pharmacokinetic model for high-dose methotrexate

2021 ◽  
Author(s):  
Giuseppe Pesenti ◽  
Marco Foppoli ◽  
Davide Manca
Keyword(s):  
Renal Function ◽  
Pharmacokinetic Model ◽  
Pbpk Model ◽  
Renal Excretion ◽  
Therapeutic Monitoring ◽  
High Dose ◽  
Physiologically Based Pharmacokinetic ◽  
Dose Methotrexate ◽  
Proposed Model ◽  
Physiologically Based

Abstract Purpose High-dose methotrexate (HDMTX) is administered for the treatment of a variety of malignant tumors. Wide intra- and inter-individual variabilities characterize the pharmacokinetics of MTX, which is mostly excreted renally. HDMTX dosages are prescribed as a function of body surface area whereas dose adjustments depending on renal function are not well defined. We develop a population pharmacokinetic model with a physiological description of renal excretion as the basis for clinical tools able to suggest model-informed dosages and support therapeutic monitoring. Methods This article presents a minimal physiologically based pharmacokinetic (PBPK) model for HDMTX, which specifically accounts for individual characteristics such as body weight, height, gender, age, hematocrit, and serum creatinine to provide individualized predictions. The model supplies a detailed and mechanistic description of capillary and cellular exchanges between plasma, interstitial fluid, and intracellular fluid compartments, and focuses on an individualized description of renal excretion. Results The minimal PBPK model is identified and validated with a literature dataset based on Chinese patients suffering from primary central nervous system lymphoma. A comparison with a pharmacokinetic model from the literature suggests that the proposed model provides improved predictions. Remarkably, the model does not present any significant bias in a wide range of degrees of renal function. Conclusion Results show that model predictions can capture the wide intra- and inter-individual variability of HDMTX, and highlight the role played by the individual degree of renal function. The proposed model can be the basis for the development of clinical decision-support systems for individualized dosages and therapeutic monitoring.

Hyperphosphataemia and Hypocalcaemia Induced by Hypertonic Phosphate Enema - An Experimental Study and Review of the Literature

1991 ◽  
Vol 10 (5) ◽  
pp. 351-355 ◽  
Author(s):  
Itamar Grosskopf ◽  
Eran Graff ◽  
Gideon Charach ◽  
Gideon Binyamin ◽  
Sara Spinrad ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Excretion ◽  
Medical Center ◽  
Inorganic Phosphorus ◽  
Phosphate Concentration ◽  
Phosphorus Level ◽  
Review Of The Literature ◽  
Study Objective ◽  
O 224 ◽  
Phosphate Enema

1 The study objective was to determine the hyperphosphataemic and hypocalcaemic effect of hypertonic phosphate enema. The study was conducted in a department of Internal Medicine at a University Medical Center. 2 Fourteen patients were studied. Patients' mean age (± s.d.) was 78.5 ± 9 years. The creatinine clearance was 48.2 ± 17.4 ml min-1 (mean ± s.d.). 3 500 ml (approx. 7 ml kg-1) of Fleet enema (FE - Na2HPO4.7H 2O 224 mmol l-1 and NaH2PO4.H 2O 1160 mmol l-1) were administered to each patient. Blood was drawn before FE administration and ½, 1, 3, 5, 12 and 24 h thereafter. Serum was analysed for levels of inorganic phosphorus and for calcium. 4 The serum inorganic phosphorus level rose from 1.01 ± 0.3 mmol l-1 to 1.4 ± 0.5 mmol l-1 ( P = 0.001) 1 h after FE was administered. Serum calcium decreased from 2.32 ± 0.12 mmol l-1 to 2.12 ± 0.1 mmol l-1 ( P < 0.001) 12 h after FE was administered. 5 We conclude that FE carries a potential risk for acutely ill elderly patients. To avoid untoward effects due to hyperphosphataemia and hypocalcaemia, the phosphate load must be adjusted to the patient's renal function, i.e. enema volume is to be lowered when phosphate concentration is high, so that if renal function is compromised the amount of phosphate absorbed does not exceed renal excretion capacity.

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