BACKGROUND AND OBJECTIVES: Intrauterine growth restriction (IUGR) and prematurity are associated with a low nephron endowment. It can therefore be expected that neonates who are born premature and/or after IUGR have a lower GFR. Measurement of GFR in neonates is difficult, but the clearance of amikacin has been proven to be a reliable marker. We hypothesized that amikacin clearance is lower after IUGR or premature birth as a marker of low nephron endowment. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Amikacin clearance was retrospectively analyzed in 161 neonates who received amikacin within the first 24 h of life. Using the MW/Pharm computer program, a population one-compartment model was calculated. The mean population pharmacokinetic parameters were individualized for each patient according to the maximum a posteriori Bayesian fitting method and provided the amikacin clearance. RESULTS: Our results show that birth weight z score and gestational age are correlated with the clearance of amikacin (partial correlation coefficient 0.159, P = 0.046, and 0.396, P < 0.001, respectively), after correction for other factors. CONCLUSIONS: We conclude that renal clearance on the first day of life is lower in neonates with a lower gestational age and/or birth weight z score. This indicates that both prematurity and IUGR impair GFR on the first day of life.
BACKGROUND AND OBJECTIVES: Intrauterine growth restriction (IUGR) and prematurity are associated with a low nephron endowment. It can therefore be expected that neonates who are born premature and/or after IUGR have a lower GFR. Measurement of GFR in neonates is difficult, but the clearance of amikacin has been proven to be a reliable marker. We hypothesized that amikacin clearance is lower after IUGR or premature birth as a marker of low nephron endowment. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Amikacin clearance was retrospectively analyzed in 161 neonates who received amikacin within the first 24 h of life. Using the MW/Pharm computer program, a population one-compartment model was calculated. The mean population pharmacokinetic parameters were individualized for each patient according to the maximum a posteriori Bayesian fitting method and provided the amikacin clearance. RESULTS: Our results show that birth weight z score and gestational age are correlated with the clearance of amikacin (partial correlation coefficient 0.159, P = 0.046, and 0.396, P < 0.001, respectively), after correction for other factors. CONCLUSIONS: We conclude that renal clearance on the first day of life is lower in neonates with a lower gestational age and/or birth weight z score. This indicates that both prematurity and IUGR impair GFR on the first day of life.
Authors: R W Jelliffe; A Schumitzky; D Bayard; M Milman; M Van Guilder; X Wang; F Jiang; X Barbaut; P Maire Journal: Clin Pharmacokinet Date: 1998-01 Impact factor: 6.447
Authors: J N van den Anker; W C Hop; R de Groot; B J van der Heijden; H M Broerse; J Lindemans; P J Sauer Journal: Pediatr Res Date: 1994-11 Impact factor: 3.756
Authors: Roosmarijn F W De Cock; Karel Allegaert; Michiel F Schreuder; Catherine M T Sherwin; Matthijs de Hoog; Johannes N van den Anker; Meindert Danhof; Catherijne A J Knibbe Journal: Clin Pharmacokinet Date: 2012-02-01 Impact factor: 6.447
Authors: Pranita D Tamma; Alison E Turnbull; Anthony D Harris; Aaron M Milstone; Alice J Hsu; Sara E Cosgrove Journal: JAMA Pediatr Date: 2013-10 Impact factor: 16.193