Prediction of glomerular filtration rate maturation across preterm and term neonates and young infants using inulin as marker

Yunjiao Wu; Karel Allegaert; Robert B Flint; Sinno H P Simons; Elke H J Krekels; Catherijne A J Knibbe; Swantje Völler

doi:10.1208/s12248-022-00688-z

Prediction of glomerular filtration rate maturation across preterm and term neonates and young infants using inulin as marker

Yunjiao Wu, Karel Allegaert, Robert B Flint, Sinno H P Simons, Elke H J Krekels, Catherijne A J Knibbe, Swantje Völler^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Describing glomerular filtration rate (GFR) maturation across the heterogeneous population of preterm and term neonates and infants is important to predict the clearance of renally cleared drugs. This study aims to describe the GFR maturation in (pre)term neonates and young infants (PNA < 90 days) using individual inulin clearance data (CL _inulin). To this end, published GFR maturation models were evaluated by comparing their predicted GFR with CL _inulin retrieved from literature. The best model was subsequently optimized in NONMEM V7.4.3 to better fit the CL _inulin values. Our study evaluated seven models and collected 381 individual CL _inulin values from 333 subjects with median (range) birthweight (BWb) 1880 g (580–4950), gestational age (GA) 34 weeks (25–43), current weight (CW) 1890 g (480–6200), postnatal age (PNA) 3 days (0–75), and CL _inulin 2.20 ml/min (0.43–17.90). The De Cock 2014 model (covariates: BWb and PNA) performed the best in predicting CL _inulin, followed by the Rhodin 2009 model (covariates: CW and postmenstrual age). The final optimized model shows that GFR at birth is determined by BWb, thereafter the maturation rate of GFR is dependent on PNA and GA, with a higher GA showing an overall faster maturation. To conclude, using individual CL _inulin data, we found that a model for neonatal GFR requires a distinction between prenatal maturation quantified by BWb and postnatal maturation. To capture postnatal GFR maturation in (pre)term neonates and young infants, we developed an optimized model in which PNA-related maturation was dependent on GA. Graphical abstract: [Figure not available: see fulltext.].

Original language	English
Article number	38
Pages (from-to)	38
Journal	AAPS Journal
Volume	24
Issue number	2
DOIs	https://doi.org/10.1208/s12248-022-00688-z
Publication status	Published - Mar 2022

Bibliographical note

Funding Information:
The authors would like to thank Kinga N. Fiebig for reviewing the codes of this paper, and Aline G.J. Engbers for providing inputs during discussion.

Publisher Copyright:
© 2022, The Author(s).

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Prediction of glomerular filtration rate maturation across preterm and term neonates and young infants using inulin as markerFinal published version, 1.85 MBLicence: CC BY

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@article{5349494b6dde405ebfc844aa64e30d78,

title = "Prediction of glomerular filtration rate maturation across preterm and term neonates and young infants using inulin as marker",

abstract = "Describing glomerular filtration rate (GFR) maturation across the heterogeneous population of preterm and term neonates and infants is important to predict the clearance of renally cleared drugs. This study aims to describe the GFR maturation in (pre)term neonates and young infants (PNA < 90 days) using individual inulin clearance data (CL inulin). To this end, published GFR maturation models were evaluated by comparing their predicted GFR with CL inulin retrieved from literature. The best model was subsequently optimized in NONMEM V7.4.3 to better fit the CL inulin values. Our study evaluated seven models and collected 381 individual CL inulin values from 333 subjects with median (range) birthweight (BWb) 1880 g (580–4950), gestational age (GA) 34 weeks (25–43), current weight (CW) 1890 g (480–6200), postnatal age (PNA) 3 days (0–75), and CL inulin 2.20 ml/min (0.43–17.90). The De Cock 2014 model (covariates: BWb and PNA) performed the best in predicting CL inulin, followed by the Rhodin 2009 model (covariates: CW and postmenstrual age). The final optimized model shows that GFR at birth is determined by BWb, thereafter the maturation rate of GFR is dependent on PNA and GA, with a higher GA showing an overall faster maturation. To conclude, using individual CL inulin data, we found that a model for neonatal GFR requires a distinction between prenatal maturation quantified by BWb and postnatal maturation. To capture postnatal GFR maturation in (pre)term neonates and young infants, we developed an optimized model in which PNA-related maturation was dependent on GA. Graphical abstract: [Figure not available: see fulltext.].",

author = "Yunjiao Wu and Karel Allegaert and Flint, {Robert B} and Simons, {Sinno H P} and Krekels, {Elke H J} and Knibbe, {Catherijne A J} and Swantje V{\"o}ller",

note = "Funding Information: The authors would like to thank Kinga N. Fiebig for reviewing the codes of this paper, and Aline G.J. Engbers for providing inputs during discussion. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

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doi = "10.1208/s12248-022-00688-z",

language = "English",

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AU - Wu, Yunjiao

AU - Allegaert, Karel

AU - Flint, Robert B

AU - Simons, Sinno H P

AU - Krekels, Elke H J

AU - Knibbe, Catherijne A J

AU - Völler, Swantje

N1 - Funding Information: The authors would like to thank Kinga N. Fiebig for reviewing the codes of this paper, and Aline G.J. Engbers for providing inputs during discussion. Publisher Copyright: © 2022, The Author(s).

PY - 2022/3

Y1 - 2022/3

N2 - Describing glomerular filtration rate (GFR) maturation across the heterogeneous population of preterm and term neonates and infants is important to predict the clearance of renally cleared drugs. This study aims to describe the GFR maturation in (pre)term neonates and young infants (PNA < 90 days) using individual inulin clearance data (CL inulin). To this end, published GFR maturation models were evaluated by comparing their predicted GFR with CL inulin retrieved from literature. The best model was subsequently optimized in NONMEM V7.4.3 to better fit the CL inulin values. Our study evaluated seven models and collected 381 individual CL inulin values from 333 subjects with median (range) birthweight (BWb) 1880 g (580–4950), gestational age (GA) 34 weeks (25–43), current weight (CW) 1890 g (480–6200), postnatal age (PNA) 3 days (0–75), and CL inulin 2.20 ml/min (0.43–17.90). The De Cock 2014 model (covariates: BWb and PNA) performed the best in predicting CL inulin, followed by the Rhodin 2009 model (covariates: CW and postmenstrual age). The final optimized model shows that GFR at birth is determined by BWb, thereafter the maturation rate of GFR is dependent on PNA and GA, with a higher GA showing an overall faster maturation. To conclude, using individual CL inulin data, we found that a model for neonatal GFR requires a distinction between prenatal maturation quantified by BWb and postnatal maturation. To capture postnatal GFR maturation in (pre)term neonates and young infants, we developed an optimized model in which PNA-related maturation was dependent on GA. Graphical abstract: [Figure not available: see fulltext.].

AB - Describing glomerular filtration rate (GFR) maturation across the heterogeneous population of preterm and term neonates and infants is important to predict the clearance of renally cleared drugs. This study aims to describe the GFR maturation in (pre)term neonates and young infants (PNA < 90 days) using individual inulin clearance data (CL inulin). To this end, published GFR maturation models were evaluated by comparing their predicted GFR with CL inulin retrieved from literature. The best model was subsequently optimized in NONMEM V7.4.3 to better fit the CL inulin values. Our study evaluated seven models and collected 381 individual CL inulin values from 333 subjects with median (range) birthweight (BWb) 1880 g (580–4950), gestational age (GA) 34 weeks (25–43), current weight (CW) 1890 g (480–6200), postnatal age (PNA) 3 days (0–75), and CL inulin 2.20 ml/min (0.43–17.90). The De Cock 2014 model (covariates: BWb and PNA) performed the best in predicting CL inulin, followed by the Rhodin 2009 model (covariates: CW and postmenstrual age). The final optimized model shows that GFR at birth is determined by BWb, thereafter the maturation rate of GFR is dependent on PNA and GA, with a higher GA showing an overall faster maturation. To conclude, using individual CL inulin data, we found that a model for neonatal GFR requires a distinction between prenatal maturation quantified by BWb and postnatal maturation. To capture postnatal GFR maturation in (pre)term neonates and young infants, we developed an optimized model in which PNA-related maturation was dependent on GA. Graphical abstract: [Figure not available: see fulltext.].

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DO - 10.1208/s12248-022-00688-z

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SN - 1550-7416

VL - 24

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JO - AAPS Journal

JF - AAPS Journal

IS - 2

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ER -

Prediction of glomerular filtration rate maturation across preterm and term neonates and young infants using inulin as marker

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