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Quantification of Fetal Renal Function Using Fetal Urine Production Rate and Its Reflection on the Amniotic and Fetal Creatinine Levels During Pregnancy

Adequate prediction of fetal exposure of drugs excreted by the kidney requires the incorporation of time-varying renal function parameters into a pharmacokinetic model. Published data on measurements of fetal urinary production rate (FUPR) and creatinine at various gestational ages were collected an...

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Autores principales: Ezuruike, Udoamaka, Blenkinsop, Alexander, Pansari, Amita, Abduljalil, Khaled
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8927781/
https://www.ncbi.nlm.nih.gov/pubmed/35311050
http://dx.doi.org/10.3389/fped.2022.841495
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author Ezuruike, Udoamaka
Blenkinsop, Alexander
Pansari, Amita
Abduljalil, Khaled
author_facet Ezuruike, Udoamaka
Blenkinsop, Alexander
Pansari, Amita
Abduljalil, Khaled
author_sort Ezuruike, Udoamaka
collection PubMed
description Adequate prediction of fetal exposure of drugs excreted by the kidney requires the incorporation of time-varying renal function parameters into a pharmacokinetic model. Published data on measurements of fetal urinary production rate (FUPR) and creatinine at various gestational ages were collected and integrated for prediction of the fetal glomerular filtration rate (GFR). The predicted GFR values were then compared to neonatal values recorded at birth. Collected data for FUPR across different gestational ages using both 3D (N = 517) and 2D (N = 845) ultrasound methods showed that 2D techniques yield significantly lower estimates of FUPR than 3D (p < 0.0001). A power law function was shown to best capture the change in FUPR with fetal age (FA) for both 2D ([Formula: see text]); and 3D ([Formula: see text]) data. The predicted FUPR based on the observed 3D data was shown to be strongly linearly related (R(2) = 0.95) to measured values of amniotic creatinine concentration (N = 664). The FUPR(3D) data together with creatinine levels in the fetal urine and serum resulted in median predicted fetal GFR values of 0.47, 1.2, 2.5, and 4.9 ml/min at 23, 28, 33, and 38 weeks of fetal age (50% CV), respectively. These values are in good agreement with neonatal values observed immediately at birth. The derived FUPR and creatinine functions can be utilized to assess fetal renal maturation and predict fetal renal clearance.
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spelling pubmed-89277812022-03-18 Quantification of Fetal Renal Function Using Fetal Urine Production Rate and Its Reflection on the Amniotic and Fetal Creatinine Levels During Pregnancy Ezuruike, Udoamaka Blenkinsop, Alexander Pansari, Amita Abduljalil, Khaled Front Pediatr Pediatrics Adequate prediction of fetal exposure of drugs excreted by the kidney requires the incorporation of time-varying renal function parameters into a pharmacokinetic model. Published data on measurements of fetal urinary production rate (FUPR) and creatinine at various gestational ages were collected and integrated for prediction of the fetal glomerular filtration rate (GFR). The predicted GFR values were then compared to neonatal values recorded at birth. Collected data for FUPR across different gestational ages using both 3D (N = 517) and 2D (N = 845) ultrasound methods showed that 2D techniques yield significantly lower estimates of FUPR than 3D (p < 0.0001). A power law function was shown to best capture the change in FUPR with fetal age (FA) for both 2D ([Formula: see text]); and 3D ([Formula: see text]) data. The predicted FUPR based on the observed 3D data was shown to be strongly linearly related (R(2) = 0.95) to measured values of amniotic creatinine concentration (N = 664). The FUPR(3D) data together with creatinine levels in the fetal urine and serum resulted in median predicted fetal GFR values of 0.47, 1.2, 2.5, and 4.9 ml/min at 23, 28, 33, and 38 weeks of fetal age (50% CV), respectively. These values are in good agreement with neonatal values observed immediately at birth. The derived FUPR and creatinine functions can be utilized to assess fetal renal maturation and predict fetal renal clearance. Frontiers Media S.A. 2022-03-03 /pmc/articles/PMC8927781/ /pubmed/35311050 http://dx.doi.org/10.3389/fped.2022.841495 Text en Copyright © 2022 Ezuruike, Blenkinsop, Pansari and Abduljalil. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Ezuruike, Udoamaka
Blenkinsop, Alexander
Pansari, Amita
Abduljalil, Khaled
Quantification of Fetal Renal Function Using Fetal Urine Production Rate and Its Reflection on the Amniotic and Fetal Creatinine Levels During Pregnancy
title Quantification of Fetal Renal Function Using Fetal Urine Production Rate and Its Reflection on the Amniotic and Fetal Creatinine Levels During Pregnancy
title_full Quantification of Fetal Renal Function Using Fetal Urine Production Rate and Its Reflection on the Amniotic and Fetal Creatinine Levels During Pregnancy
title_fullStr Quantification of Fetal Renal Function Using Fetal Urine Production Rate and Its Reflection on the Amniotic and Fetal Creatinine Levels During Pregnancy
title_full_unstemmed Quantification of Fetal Renal Function Using Fetal Urine Production Rate and Its Reflection on the Amniotic and Fetal Creatinine Levels During Pregnancy
title_short Quantification of Fetal Renal Function Using Fetal Urine Production Rate and Its Reflection on the Amniotic and Fetal Creatinine Levels During Pregnancy
title_sort quantification of fetal renal function using fetal urine production rate and its reflection on the amniotic and fetal creatinine levels during pregnancy
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8927781/
https://www.ncbi.nlm.nih.gov/pubmed/35311050
http://dx.doi.org/10.3389/fped.2022.841495
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