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Drug dosage in children with reduced renal function

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Abstract

Drug dosing in paediatric nephrology requires multiple considerations and is therefore time-consuming and error-prone. This review combines dose adjustment guidelines for children with renal failure and information on the immature renal function of neonates and premature babies in order to help both paediatric nephrologists and neonatologists estimate drug doses for their patients.

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References

  1. Rane A (1992) Drug disposition and action in infants and children. In: Yaffe SJ, Aranda JV (eds) Pediatric Pharmacology. WB Saunders, Philadelphia, pp 10–21

  2. Port RE, Kiepe D, Van Guilder M, Jelliffe RW, Mehls O (2004) Recombinant human erythropoietin for the treatment of renal anaemia in children: no justification for bodyweight-adjusted dosage. Clin Pharmacokinet 43:57–70

    PubMed  Google Scholar 

  3. Hyvärinen M, Zeltzer P, Oh W, Stiehm ER (1973) Influence of gestational age on serum levels of alpha-1 fetoprotein, IgG globulin, and albumin in newborn infants. J Pediatr 82:430–437

    PubMed  Google Scholar 

  4. Wood M, Wood AJJ (1981) Changes in plasma drug binding and alpha-1-glycoprotein in mother and newborn infant. Clin Pharmacol Ther 29:522–566

    PubMed  Google Scholar 

  5. Rane A, Lunde PK, Jalling B, Yaffe SJ, Sjöqvist F (1971) Plasma protein binding of diphenylhydantoin in normal and hyperbilirubinemic infants. J Pediatr 78:877–882

    PubMed  Google Scholar 

  6. Dasgupta A, Crossey MJ (1997) Elevated free fatty acid concentrations in lipemic sera reduce protein binding of valproic acid significantly more than phenytoin. Am J Med Sci 313:75–79

    Article  PubMed  Google Scholar 

  7. Pacifici GM, Taddeucci-Brunelli G, Rane A (1984) Clonazepam serum protein binding during development. Clin Pharmacol Ther 35:354–359

    PubMed  Google Scholar 

  8. Fawer CL, Torrado A, Guignard JP (1979) Maturation of renal function in full-term and premature neonates. Helv Paediatr Acta 34:11–21

    PubMed  Google Scholar 

  9. Stewart CF, Hampton EM (1987) Effect of maturation on drug disposition in pediatric patients. Clin Pharmacol 6:548–564

    Google Scholar 

  10. Lebenthal E, Lee PC, Heitlinger LA (1983) Impact of development of the gastrointestinal tract on infant feeding. J Pediatr 102:1–9

    PubMed  Google Scholar 

  11. Del Olmo E, Pazos A (2001) Aminergic receptors during the development of the human brain: the contribution of in vitro imaging techniques. J Chem Neuroanatom 22:101–114

    Article  Google Scholar 

  12. Mato S, Del Olmo E, Pazos A (2003) Ontogenetic development of cannabinoid receptor expression and signal transduction functionality in the human brain. Eur J Neurosci 17:1747–1754

    Article  PubMed  Google Scholar 

  13. Höcker B, John U, Plank C et al (2004) Successful withdrawal of steroids in pediatric renal transplant recipients receiving cyclosporine A and mycophenolate mofetil treatment: results after four years. Transplantation 78:228–234

    PubMed  Google Scholar 

  14. Fleming P, Witkop CJJ, Kuhlmann WH (1987) Staining and hypoplasia of enamel caused by tetracycline: case report. Pediatr Dent 9:245–246

    PubMed  Google Scholar 

  15. Greenglass EJ (1992) The adverse effects of cocaine on the developing human. In: Yaffe SJ, Aranda JV (eds) Pediatric pharmacology. WB Saunders, Philadelphia, pp 598–604

  16. Pharmaceutical companies (1993) Drug information sheets

  17. Yee CL, Duffy C, Gerbino PG, Stryker S, Noel GJ (2002) Tendon or joint disorders in children after treatment with fluoroquinolones or azithromycin. Pediatr Infect Dis J 21:525–529

    Article  PubMed  Google Scholar 

  18. Chauvin M, Sandouk P, Scherrmann JM et al (1987) Morphine pharmacokinetics in renal failure. Anesthesiology 66:327–331

    PubMed  Google Scholar 

  19. Bennett WM (1981) Altering drug dose in patients with diseases of the kidney and liver. In: Anderson RJ, Schrier RW (eds) Clinical use of drugs in patients with kidney and liver disease. WB Saunders, Philadelphia, pp 16–29

  20. Heymsfield SB, Arteaga C, McManus C, Smith J, Moffitt S (1983) Measurement of muscle mass in humans: validity of the 24-hour urinary creatinine method. Am J Clin Nutr 37:478–494

    PubMed  Google Scholar 

  21. Levey AS (1990) Measurement of renal function in chronic renal disease. Kidney Int 38:167–184

    PubMed  Google Scholar 

  22. Trompeter RS (1987) A review of drug prescribing in children with end-stage renal failure. Pediatr Nephrol 1:183–194

    Article  PubMed  Google Scholar 

  23. Schaefer F, Klaus G, Müller-Wiefel DE, Mehls O, Mid European Pediatric Peritoneal Dialysis Study Group (MEPPS) (1999) Intermittent versus continuous intraperitoneal glycopeptide/ceftazidime treatment in children with peritoneal dialysis-associated peritonitis. J Am Soc Nephrol 10:136–145

    PubMed  Google Scholar 

  24. Carmichael DHS (2005) Handling of drugs in kidney disease. In: Davison AM, Cameron JS, Grünfeld J-P et al (eds) Oxford textbook of clinical nephrology. Oxford University Press, Oxford, pp 2599–2618

  25. Forth W, Henschler D, Rummel W (1988) Pharmakologie und Toxikologie. BI Wissenschaftsverlag, Mannheim

  26. De Broe ME (2005) Drug-induced nephropathies. In: Davison AM, Cameron JS, Grünfeld J-P et al (eds) Oxford textbook of clinical nephrology. Oxford University Press, Oxford, pp 2581–2598

  27. Gambertoglio JG, Lauer RM (1981) Use of neuropsychiatric drugs. In: Anderson RJ, Schrier RW (eds) Clinical use of drugs in patients with kidney and liver disease. WB Saunders, Philadelphia, pp 276–295

  28. Sontheimer, D (1993) Dosierungen in der pädiatrischen Intensivtherapie. Dosage tables of the University Children’s Hospital, Heidelberg

  29. Milatovic D, Braveny I (1995) Praktische Hinweise zur antimikrobiellen Therapie und Diagnostik. MMW-Medizin Verlag, Munich

  30. Daschner F (2002) Antibiotika am Krankenbett. Springer Verlag, Berlin, Heidelberg, New York

  31. Rote L. Rote Liste (German Drug Index) (2003) Editio Cantor, Aulendorf, Germany

  32. MicroMedex (1997) DrugKnowledge System (pharmacological database)

  33. Adelman RD, Sinaiko AR (1987) Drugs and the kidney. In: Holliday MA, Barratt TM, Vernier RL (eds) Pediatric nephrology. Williams & Wilkins, Baltimore

  34. Anderson RC, Gambertoglio JG, Schrier RW (1978) Clinical use of drugs in renal failure. CC Thomas Publisher, Springfield, IL

  35. Bennett WM (1986) Prescribing drugs for patients with reduced renal function. In: Bennett WM (ed) Drugs and renal disease. Churchill Livingstone, Edinburgh, pp 26–65

  36. Büchele W (1996) Arzneimitteldosierung bei Niereninsuffizienz. Janssen-Cilag Biotech, Neuss, Germany

  37. Keller F (1997) Pharmakokinetik bei Niereninsuffizienz. In: Brass, Philipp, Schulz (eds) Manuale Nephrologicum. Dustri-Verlag, Munich

  38. Müller-Wiefel DE (1989) Niere und Medikamente. In: Bachmann KD, Ewerbeck H, Kleihauer E, Russi E, Stalder G (eds) Pädiatrie in Praxis und Klinik. Georg Thieme Verlag, Stuttgart, pp 189–193

  39. Seyffart G (1991) Drug dosage in renal insufficiency. Kluwer Academic Publishers, Boston

  40. Weber LT, Shipkova M, Lamersdorf T et al (1998) Pharmacokinetics of mycophenolic acid (MPA) and determinants of MPA free fraction in pediatric and adult renal transplant recipients. German Study Group on Mycophenolate Mofetil Therapy in Pediatric Renal Transplant Recipients. J Am Soc Nephrol 9:1511–1520

    PubMed  Google Scholar 

  41. Keane WF, Alexander SR, Bailie GR et al (1996) Peritoneal dialysis-related peritonitis treatment recommendations: 1996 update. Perit Dial Int 16:557–573

    PubMed  Google Scholar 

  42. Warady BA, Schaefer F, Holloway M et al (2000) Consensus guidelines for the treatment of peritonitis in pediatric patients receiving peritoneal dialysis. Perit Dial Int 10:610–624

    Google Scholar 

  43. Daschner M (2003) Tabellarium Nephrologicum. Shaker Verlag, Aachen

  44. Daschner M, Cochat P (2002) Pharmakotherapie bei Niereninsuffizienz. In: Schärer K, Mehls O (eds) Pädiatrische Nephrologie. Springer Verlag, Berlin, Heidelberg, New York, pp 467–482

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Acknowledgements

The author is grateful to O. Mehls and F. Schaefer for critical and thorough review of the manuscript. I would like to thank P. Cochat and K. Schärer for helpful comments on the initial compilation of the dosing tables. Parts of this work have been published previously by Shaker Verlag, Aachen, Germany (from [43], with permission) and by Springer Verlag, Heidelberg, Germany (from [44], with permission).

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  1. Division of Paediatric Nephrology, University Children’s Hospital, Im Neuenheimer Feld 150, 69120 , Heidelberg, Germany

    Markus Daschner

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  1. Markus Daschner
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Correspondence to Markus Daschner.

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Legal disclaimer Every effort has been made to ensure that the data published in this text are in accordance with current dosage recommendations and clinical practice at the time of publication. However, the present document can lay no claim to completeness nor should it be construed as a definitive guide to clinical practice. Each user must confirm the data prior to drug prescription. Furthermore, national government regulations must also be observed.

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Daschner, M. Drug dosage in children with reduced renal function. Pediatr Nephrol 20, 1675–1686 (2005). https://doi.org/10.1007/s00467-005-1922-9

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