Renal Tubular Transport of Calcium

Costanzo, Linda S.; Windhager, Erich E.

doi:10.1002/cphy.cp080236

Cited by 5 publications

(4 citation statements)

References 197 publications

(236 reference statements)

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“…There is rapid maturation of GFR during the early neonatal period, which may be initiated by hemodynamic factors, such as cardiac output, vascular resistance, and mean arterial blood pressure 38 . In the circuitry of the cardiovascular system, the distribution of cardiac output to the kidneys is 25%, which is the highest volume of blood flow compared with the other organs 39 . For fetal physiological‐based PK modeling, the percentage of cardiac output to the kidneys is the third highest followed by the brain and lungs 40 .…”

Section: Discussionmentioning

confidence: 99%

Model‐Informed Vancomycin Dosing Optimization to Address Delayed Renal Maturation in Infants and Young Children with Critical Congenital Heart Disease

Shimamoto,

Fukushima,

Mizuno

et al. 2023

Clin Pharma and Therapeutics

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Ensuring safe and effective drug therapy in infants and young children often requires accounting for growth and organ development; however, data on organ function maturation are scarce for special populations, such as infants with congenital diseases. Children with critical congenital heart disease (CCHD) often require multiple staged surgeries depending on their age and disease severity. Vancomycin (VCM) is used to treat postoperative infections; however, the standard pediatric dose (60–80 mg/kg/day) frequently results in overexposure in children with CCHD. In this study, we characterized the maturation of VCM clearance in pediatric patients with CCHD and determined the appropriate dosing regimen using population pharmacokinetic (PK) modeling and simulations. We analyzed 1,254 VCM serum concentrations from 152 postoperative patients (3 days–13 years old) for population PK analysis. The PK model was developed using a two‐compartment model with allometrically scaled body weight, estimated glomerular filtration rate (eGFR), and postmenstrual age as covariates. The observed clearance in patients aged ≤ 1 year and 1–2 years was 33% and 40% lower compared with that of non‐CCHD patients, respectively, indicating delayed renal maturation in patients with CCHD. Simulation analyses suggested VCM doses of 25 mg/kg/day (age ≤ 3 months, eGFR 40 mL/min/1.73 m2) and 35 mg/kg/day (3 months < age ≤ 3 years, eGFR 60 mL/min/1.73 m2). In conclusion, this study revealed delayed renal maturation in children with CCHD, could be due to cyanosis and low cardiac output. Model‐informed simulations identified the lower VCM doses for children with CCHD compared with standard pediatric guidelines.

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Section: Discussionmentioning

confidence: 99%

Model‐Informed Vancomycin Dosing Optimization to Address Delayed Renal Maturation in Infants and Young Children with Critical Congenital Heart Disease

Shimamoto,

Fukushima,

Mizuno

et al. 2023

Clin Pharma and Therapeutics

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“…About 20% of the filtered load of calcium is reabsorbed in the thick ascending limb of the loop of Henle; another 10–15% of filtered calcium is reabsorbed in the distal tubule with the remaining 5% being reabsorbed in the collecting duct [2, 3, 28, 29]. The movement of calcium in the distal nephron is energy dependent and occurs against a concentration gradient; furthermore, the tubular lumen is electro-negative and becomes progressively more so towards the end of the distal tubule [30, 31]. In the distal nephron, calcium reabsorption can be dissociated from sodium reabsorption by thiazide diuretics which inhibit sodium reabsorption but enhance calcium reabsorption [30, 31].…”

Section: Calcium and Phosphorus Filtration And Reabsorption In Thementioning

confidence: 99%

“…The movement of calcium in the distal nephron is energy dependent and occurs against a concentration gradient; furthermore, the tubular lumen is electro-negative and becomes progressively more so towards the end of the distal tubule [30, 31]. In the distal nephron, calcium reabsorption can be dissociated from sodium reabsorption by thiazide diuretics which inhibit sodium reabsorption but enhance calcium reabsorption [30, 31]. In contrast to the proximal tubule, where hydrogen ion have no effect on calcium reabsorption, in the distal nephron hydrogen ions inhibit calcium reabsorption.…”

Section: Calcium and Phosphorus Filtration And Reabsorption In Thementioning

confidence: 99%

Vitamin D and the kidney

Kumar¹,

Tebben²,

Thompson³

2012

Archives of Biochemistry and Biophysics

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“…Calcium (Ca 2+ ) is the most abundant cation in the human body wherein the largest reservoir for Ca 2+ is the bone (107). Under normal conditions, extracellular fluid calcium concentration in the kidney remains tightly controlled, but when it decreases the bone acts as a large reservoir and source of calcium.…”

Section: Introductionmentioning

confidence: 99%

Regulation of Transport in the Connecting Tubule and Cortical Collecting Duct

Staruschenko

2012

Comprehensive Physiology

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The central goal of this overview article is to summarize recent findings in renal epithelial transport, focusing chiefly on the connecting tubule (CNT) and the cortical collecting duct (CCD). Mammalian CCD and CNT are involved in fine tuning of electrolyte and fluid balance through reabsorption and secretion. Specific transporters and channels mediate vectorial movements of water and solutes in these segments. Although only a small percent of the glomerular filtrate reaches the CNT and CCD, these segments are critical for water and electrolyte homeostasis since several hormones, e.g. aldosterone and arginine vasopressin, exert their main effects in these nephron sites. Importantly, hormones regulate the function of the entire nephron and kidney by affecting channels and transporters in the CNT and CCD. Knowledge about the physiological and pathophysiological regulation of transport in the CNT and CCD and particular roles of specific channels/transporters has increased tremendously over the last two decades. Recent studies shed new light on several key questions concerning the regulation of renal transport. Precise distribution patterns of transport proteins in the CCD and CNT will be reviewed, and their physiological roles and mechanisms mediating ion transport in these segments will be also covered. Special emphasis will be given to pathophysiological conditions appearing as a result of abnormalities in renal transport in the CNT and CCD.

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Renal Tubular Transport of Calcium

Abstract: The sections in this article are: Calcium Handling in the Nephron Glomerular Filtration Proximal Tubule Thick Ascending Limb of Henle's Loop Distal Tubule Regulation of Renal Tubular Calcium Transport Extracellular Fluid Volume Hyp… Show more

Cited by 5 publications

References 197 publications

Model‐Informed Vancomycin Dosing Optimization to Address Delayed Renal Maturation in Infants and Young Children with Critical Congenital Heart Disease

Model‐Informed Vancomycin Dosing Optimization to Address Delayed Renal Maturation in Infants and Young Children with Critical Congenital Heart Disease

Vitamin D and the kidney

Regulation of Transport in the Connecting Tubule and Cortical Collecting Duct

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