From mechanisms to clinical practice: a review of diuretic therapy in pediatric nephrology - PubMed
18 hours ago
- #diuretics
- #kidney disease
- #pediatric nephrology
- Diuretics are essential supportive therapy in pediatric nephrology for managing edema, fluid overload, hypertension, and kidney diseases.
- Clinical use is affected by developmental kidney physiology, age-related pharmacokinetics, underlying diseases, and unique pediatric adverse effects.
- Review covers pharmacology, mechanisms, indications, drug interactions, safety, and roles in conditions like nephrotic syndrome, CKD, AKI, hypertension, hypercalcemia, hypercalciuria, and nephrogenic diabetes insipidus.
- Special populations include neonates and adolescents, with focus on developmental pharmacology, toxicity risks, and long-term growth and bone health concerns.
- Emerging therapies discussed: sodium-glucose cotransporter-2 inhibitors, vasopressin receptor antagonists, and non-steroidal mineralocorticoid receptor antagonists, noting limited pediatric evidence.
- Adverse effects addressed: electrolyte disturbances, nephrocalcinosis, ototoxicity, metabolic complications, with monitoring recommendations.
- Emphasis on judicious, individualized use based on age and kidney function, close monitoring, and integration with definitive therapies.