Pediatric Nephrology

, Volume 21, Issue 2, pp 160–168

Ontogeny of drug elimination by the human kidney

  • Nancy Chen
  • Katarina Aleksa
  • Cindy Woodland
  • Michael Rieder
  • Gideon Koren
Review

DOI: 10.1007/s00467-005-2105-4

Cite this article as:
Chen, N., Aleksa, K., Woodland, C. et al. Pediatr Nephrol (2006) 21: 160. doi:10.1007/s00467-005-2105-4

Abstract

Renal clearance is an important route of drug elimination. While during the neonatal period there is minimal glomerular filtration and active tubular secretion of drugs, there is a well-described rapid development in these processes in the post-neonatal period. A less appreciated fact is that during toddlerhood, there is an “overshoot” of the glomerular filtration rate (GFR) well above the levels encountered in older children and adults, and there is an early achievement of adult levels in active drug secretion, which stays at a plateau throughout childhood and adulthood with an “overshoot” in toddlers due to specific transport mechanisms. This phenomenon leads to dose requirements for renally excreted drugs in this age group being, on a per-kilogram basis, much larger than in adults. This review discusses the mechanisms related to renal ontogeny in drug handling.

Keywords

Kidney Ontogeny Renal clearance Glomerular filtration Tubular secretion Dosages Toddlerhood 

Copyright information

© IPNA 2005

Authors and Affiliations

  • Nancy Chen
    • 1
  • Katarina Aleksa
    • 2
  • Cindy Woodland
    • 2
    • 3
  • Michael Rieder
    • 4
    • 5
  • Gideon Koren
    • 1
    • 2
  1. 1.Department of Physiology and PharmacologySchulich School of Medicine and Dentistry, University of Western OntarioLondonCanada
  2. 2.Division of Clinical Pharmacology and ToxicologyHospital for Sick ChildrenTorontoCanada
  3. 3.Department of PharmacologyFaculty of Medicine, University of Toronto OntarioCanada
  4. 4.Department of Physiology and Pharmacology and PediatricsSchulich School of Medicine and Dentistry, University of Western OntarioLondonCanada
  5. 5.Department of PediatricsChildren’s Hospital of Western OntarioLondonCanada

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