Pharmacokinetics in children with chronic kidney disease.

In children, the main causes of chronic kidney disease (CKD) are congenital diseases and glomerular disorders. CKD is associated with multiple physiological changes and may therefore influence various pharmacokinetic (PK) parameters. A well-known consequence of CKD on pharmacokinetics is a reduction...

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Publicado en:Pediatric Nephrology Vol. 35; no. 7; pp. 1153 - 1173
Autores principales: Schijvens, Anne M., de Wildt, Saskia N., Schreuder, Michiel F.
Formato: review tables/charts Journal Article
Publicado: Springer Nature Jul2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2020
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00467-019-04304-9
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        atl: Pharmacokinetics in children with chronic kidney disease.
      aug:
        au:
          Schijvens, Anne M.
          de Wildt, Saskia N.
          Schreuder, Michiel F.
        affil: Radboud Institute for Molecular Life Sciences, Department of Pediatric Nephrology, Radboud University Medical Center, Amalia Children's Hospital, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
      sug:
        subj:
          Kidney Failure, Chronic In Infancy and Childhood
          Pharmacokinetics
          Glomerular Filtration Rate
          Drugs Metabolism
          Drug Toxicity
          Child
          Metabolic Clearance Rate
          Intestinal Absorption
          Child: 6-12 years
      ab: In children, the main causes of chronic kidney disease (CKD) are congenital diseases and glomerular disorders. CKD is associated with multiple physiological changes and may therefore influence various pharmacokinetic (PK) parameters. A well-known consequence of CKD on pharmacokinetics is a reduction in renal clearance due to a decrease in the glomerular filtration rate. The impact of renal impairment on pharmacokinetics is, however, not limited to a decreased elimination of drugs excreted by the kidney. In fact, renal dysfunction may lead to modifications in absorption, distribution, transport, and metabolism as well. Currently, insufficient evidence is available to guide dosing decisions on many commonly used drugs. Moreover, the impact of maturation on drug disposition and action should be taken into account when selecting and dosing drugs in the pediatric population. Clinicians should take PK changes into consideration when selecting and dosing drugs in pediatric CKD patients in order to avoid toxicity and increase efficiency of drugs in this population. The aim of this review is to summarize known PK changes in relation to CKD and to extrapolate available knowledge to the pediatric CKD population to provide guidance for clinical practice.
      pubtype: Academic Journal
      doctype:
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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