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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

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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...
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Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Related Experiment Video

Updated: Dec 3, 2025

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
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Hypercalcemia in Children Using the Ketogenic Diet: A Multicenter Study.

Colin P Hawkes1,2, Sani M Roy3, Bassem Dekelbab4

  • 1Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

The Journal of Clinical Endocrinology and Metabolism
|October 30, 2020
PubMed
Summary

Acute hypercalcemia is a complication of the ketogenic diet, particularly in children with impaired renal function. Early screening and bone health optimization are recommended for patients on this diet.

Keywords:
hypercalcemiahypercalciuriaketogenic dietnephrocalcinosis

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Area of Science:

  • Pediatric Endocrinology
  • Nephrology
  • Metabolic Disorders

Background:

  • The ketogenic diet is linked to bone demineralization and kidney stones.
  • Acute hypercalcemia is a newly identified complication of ketogenic diet therapy.

Purpose of the Study:

  • To detail the clinical features of acute hypercalcemia in children undergoing ketogenic diet treatment.
  • To analyze presentation, treatment response, and outcomes in a large patient cohort.

Main Methods:

  • A multicenter case series was conducted.
  • Data on clinical presentation, treatment, and outcomes were collected for children with ketogenic diet-associated hypercalcemia.

Main Results:

  • 14 children (median age 6.3 years) developed hypercalcemia 2.1 years after starting the diet.
  • Most patients had low parathyroid hormone and 1,25-dihydroxyvitamin D levels; 50% had impaired renal function.
  • Hypercalcemia recurrence was low (2/14) after achieving normocalcemia, with most patients continuing or discontinuing the diet post-resolution.

Conclusions:

  • Ketotic hypercalcemia can manifest years after initiating the ketogenic diet, especially with renal impairment.
  • The mechanism may involve reduced osteoblast activity and bone formation.
  • Close monitoring of bone health and screening for hypercalcemia are advised for children on ketogenic diets.