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肾毒性药物对儿童肾功能的影响及其安全使用
作者:孙田  肖建明  陈金龙  张彩霞 
单位:南京医科大学附属儿童医院 麻醉手术科, 江苏 南京 210008
关键词:儿童 肾功能 肾毒性 药物安全 抗感染药物 
分类号:R72
出版年·卷·期(页码):2023·51·第一期(144-149)
摘要:

与成年人相比,儿童肾脏功能发育不足,主要原因包括: (1) 肾小球滤过以及肾小管分泌和重吸收功能不成熟;(2) 肾脏灌注压较低;(3) 渗透负荷不足,不能产生完全的逆流效应。不成熟的肾功能可能导致药物排泄减慢和经肾排泄的药物产生蓄积等,可能进一步损害儿童肾功能。鉴于儿童不成熟的肾功能对药代动力学和毒性特征的影响,对于本身具有潜在肾毒性的药物在儿童用药时更应该谨慎和重视,以防用药过程中进一步损害脆弱的肾功能,造成严重后果。本文以儿科常用的抗炎和抗感染药物为例,探讨其对儿童肾功能的影响以及上述药物的安全使用。

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