Assessment of Glomerular Filtration Rate in Preterm Infants by Serum Creatinine: Comparison With Inulin Clearance

Jn, van den Anker; R, de Groot; Hm, Broerse; Pj, Sauer; Bj, van der Heijden; Wc, Hop; Lindemans, Jan

doi:10.1542/peds.96.6.1156

Cited by 52 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Serum creatinine (SCR) and (estimated) glomerular filtration rate (GFR) are commonly used clinically to evaluate kidney function, although these are not ideal markers for early detection and monitoring renal and particularly tubular injury in pediatrics [2,3]. The most accurate assessment of GFR using inulin or iohexol is cumbersome, invasive and not suitable for regular monitoring of kidney function [4]. This is particularly true for the pediatric population.…”

Section: Introductionmentioning

confidence: 99%

Age appropriate reference intervals for eight kidney function and injury markers in infants, children and adolescents

Donge

Staub

Atkinson

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

View full text Add to dashboard Cite

ObjectivesThe use of kidney function and injury markers for early detection of drug-related glomerular or tubular kidney injury in infants, children and adolescents requires age-specific data on reference intervals in a pediatric healthy population. This study characterizes serum values for eight kidney function and injury markers in healthy infants, children and adolescents.MethodsA single center prospective observational study was conducted between December 2018 and June 2019. Serum samples from 142 healthy infants, children and adolescents aged between 0 and ≤15 years were collected. Statistical analyses for eight markers (albumin (ALB), β2-microglobulin (B2M), β-trace protein (BTP), creatinine (SCR), cystatin C (CYSC), kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), uromodulin (URO)) were performed to obtain reference intervals and associations with age, sex and weight were investigated (Pearson correlation, linear and piecewise regression).ResultsALB and SCR increased with age (p<0.01), whereas B2M, BTP and KIM-1 values decreased with advancing age (p<0.05) in this healthy pediatric study population. CYSC showed dependency on sex (lower concentration in females) and decreased with age until reaching approximately 1.8 years; thereafter an increase with age was seen. NGAL and URO did not show any age-dependency.ConclusionsThis study provides age appropriate reference intervals for key serum kidney function and injury markers determined in healthy infants, children and adolescents. Such reference intervals facilitate the interpretation of changes in kidney function and injury markers in daily practice, and allow early detection of glomerular and tubular injury in infancy, childhood and adolescence.

show abstract

Section: Introductionmentioning

confidence: 99%

Age appropriate reference intervals for eight kidney function and injury markers in infants, children and adolescents

Donge

Staub

Atkinson

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

View full text Add to dashboard Cite

show abstract

“…Finally, it is worth noting that creatinine at birth is not the ideal marker for glomerular filtration, because, in the first few hours of life, it reflects the mother’s renal function [ 65 ]. However, it becomes more reliable after the first weeks of post-natal life [ 66 ].…”

Section: Pharmacological Considerations In Preterm Newbornsmentioning

confidence: 99%

Use of Antibiotics in Preterm Newborns

et al. 2022

View full text Add to dashboard Cite

Due to complex maturational and physiological changes that characterize neonates and affect their response to pharmacological treatments, neonatal pharmacology is different from children and adults and deserves particular attention. Although preterms are usually considered part of the neonatal population, they have physiological and pharmacological hallmarks different from full-terms and, therefore, need specific considerations. Antibiotics are widely used among preterms. In fact, during their stay in neonatal intensive care units (NICUs), invasive procedures, including central catheters for parental nutrition and ventilators for respiratory support, are often sources of microbes and require antimicrobial treatments. Unfortunately, the majority of drugs administered to neonates are off-label due to the lack of clinical studies conducted on this special population. In fact, physiological and ethical concerns represent a huge limit in performing pharmacokinetic (PK) studies on these subjects, since they limit the number and volume of blood sampling. Therapeutic drug monitoring (TDM) is a useful tool that allows dose adjustments aiming to fit plasma concentrations within the therapeutic range and to reach specific drug target attainment. In this review of the last ten years’ literature, we performed Pubmed research aiming to summarize the PK aspects for the most used antibiotics in preterms.

show abstract

“…A sensitivity analysis was also performed for patients with absolute values for conditional weighted residuals (jCWRESj) >3. 26,27…”

Section: Model Selection and Parameter Estimationmentioning

confidence: 99%

Dosing strategies of imipenem in neonates based on pharmacometric modelling and simulation

Dao

Fuchs

André

et al. 2021

Journal of Antimicrobial Chemotherapy

View full text Add to dashboard Cite

Objectives Imipenem is a broad-spectrum antibacterial agent used in critically ill neonates after failure of first-line treatments. Few studies have described imipenem disposition in this population. The objectives of our study were: (i) to characterize imipenem population pharmacokinetics (PK) in a cohort of neonates; and (ii) to conduct model-based simulations to evaluate the performance of six different dosing regimens aiming at optimizing PK target attainment. Methods A total of 173 plasma samples from 82 neonates were collected over 15 years at the Lausanne University Hospital, Switzerland. The majority of study subjects were preterm neonates with a median gestational age (GA) of 27 weeks (range: 24–41), a postnatal age (PNA) of 21 days (2–153) and a body weight (BW) of 1.16 kg (0.5–4.1). PK data were analysed using non-linear mixed-effect modelling (NONMEM). Results A one-compartment model best characterized imipenem disposition. Population PK parameters estimates of CL and volume of distribution were 0.21 L/h and 0.73 L, with an interpatient variability (CV%) of 20.1% on CL in a representative neonate (GA 27 weeks, PNA 21 days, BW 1.16 kg, serum creatinine, SCr 46.6 μmol/L). GA and PNA exhibited the greatest impact on PK parameters, followed by SCr. These covariates explained 36% and 15% of interindividual variability in CL, respectively. Simulated regimens using a dose of 20–25 mg/kg every 6–12 h according to postnatal age led to the highest PTA (T>MIC over 100% of time). Conclusions Dosing adjustment according to BW, GA and PNA optimizes imipenem exposure in neonates.

show abstract

Assessment of Glomerular Filtration Rate in Preterm Infants by Serum Creatinine: Comparison With Inulin Clearance

Cited by 52 publications

References 0 publications

Age appropriate reference intervals for eight kidney function and injury markers in infants, children and adolescents

Age appropriate reference intervals for eight kidney function and injury markers in infants, children and adolescents

Use of Antibiotics in Preterm Newborns

Dosing strategies of imipenem in neonates based on pharmacometric modelling and simulation

Contact Info

Product

Resources

About