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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Impact of Pharmacokinetic–Pharmacodynamic Models: Regulatory Decisions01:15

Impact of Pharmacokinetic–Pharmacodynamic Models: Regulatory Decisions

PK–PD modeling has significantly influenced FDA regulatory decisions, particularly drug approval, dosage optimization, and labeling. These models integrate pharmacokinetics (PK) and pharmacodynamics (PD) to predict drug behavior and effects, aiding in optimizing dosing regimens and enhancing the probability of clinical trial success.One notable example is Nesiritide (Natrecor®), a recombinant human brain natriuretic peptide for treating acute decompensated congestive heart failure (CHF).

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Determination of ceftriaxone sodium in pharmaceutical formulations by flow injection analysis with acid potassium permanganate chemiluminescence detection.

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Related Experiment Video

Updated: Jul 15, 2026

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
11:27

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

Published on: April 7, 2023

Optimizing outcomes for neonatal ARPKD.

Mona Beaunoyer1, Mohile Snehal, Li Li

  • 1Department of Transplant Surgery, Stanford University, Stanford, CA 94304, USA.

Pediatric Transplantation
|April 14, 2007
PubMed
Summary

Pre-emptive nephrectomy and peritoneal dialysis in neonatal Autosomal Recessive Polycystic Kidney Disease (ARPKD) improve nutrition and respiratory status, enabling successful kidney transplants with excellent long-term outcomes.

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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography

Published on: January 27, 2023

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Last Updated: Jul 15, 2026

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
11:27

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

Published on: April 7, 2023

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
09:31

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography

Published on: January 27, 2023

Area of Science:

  • Pediatric Nephrology
  • Transplant Surgery
  • Medical Genetics

Background:

  • Autosomal Recessive Polycystic Kidney Disease (ARPKD) is a severe genetic disorder.
  • Neonatal ARPKD often presents with massive kidneys, leading to respiratory compromise and feeding difficulties.
  • Kidney transplantation (KT) is a critical intervention for end-stage renal disease in ARPKD.

Purpose of the Study:

  • To evaluate the impact of pre-emptive bilateral nephrectomy and peritoneal dialysis (PD) on neonatal ARPKD patients.
  • To assess the outcomes of kidney transplantation in this cohort.
  • To analyze patient survival and graft function post-transplantation.

Main Methods:

  • Retrospective analysis of 10 neonatal ARPKD cases.
  • Documentation of antenatal or birth diagnosis.
  • Surgical intervention: pre-emptive bilateral nephrectomy and PD catheter placement.
  • Nutritional support: assisted enteral nutrition.
  • Kidney transplantation details: age, weight, and follow-up duration.
  • Assessment of renal function (creatinine clearance) and survival rates.

Main Results:

  • 70% of patients required ventilatory support in the first month.
  • Pre-emptive nephrectomy and PD improved nutritional intake and growth (p < 0.05).
  • Mean age at KT was 2.5 years, with mean creatinine clearance of 91.3 ml/min/1.73 m² at one year post-KT.
  • Patient survival was 89%, and death-censored graft survival was 100% at a mean follow-up of 6.1 years.
  • Six patients had hepatic fibrosis; one required liver transplantation.

Conclusions:

  • Pre-emptive bilateral nephrectomy, supportive PD, and early aggressive nutrition are crucial for managing massive kidneys in neonatal ARPKD.
  • These interventions minimize early infant mortality, facilitating successful kidney transplantation with excellent patient and graft survival.
  • Multidisciplinary management is essential for optimizing outcomes in pediatric ARPKD patients requiring transplantation.