Improving Pneumococcal Vaccination Rates in High-risk Children in Specialty Clinics.

Background And Objectives: Pediatric patients with immunocompromising or certain chronic medical conditions have an increased risk of acquiring invasive pneumococcal disease (IPD). The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is recommended for patients ≥2 years at high risk for IPDs. The aim of this project was to improve PPSV23 vaccination rates for children at high risk for IPD who were seen in 3 specialty clinics from ∼20% to 50% over a 12-month period.

Diuretics in the treatment of hypertension.

Diuretics have long been used for the treatment of hypertension. Thiazide diuretics are the most commonly prescribed diuretics for hypertension, but other classes of diuretics may be useful in alternative circumstances. Although diuretics are no longer considered the preferred agent for treatment of hypertension in adults and children, they remain acceptable first-line options.

Pharmacokinetics of olmesartan medoxomil in pediatric patients with hypertension.

Background: The prevalence and importance of hypertension in younger patients is becoming increasingly recognized; however, only a limited number of clinical trials have been conducted in the pediatric population.

Objective: The aim of this study was to characterize the pharmacokinetics and short-term safety of olmesartan medoxomil in children and adolescents with hypertension.

Methods: An open-label, multicenter, single-dose study was conducted in children and adolescents aged 12 months-16 years who were receiving treatment for hypertension or, if not currently treated for hypertension, had either a systolic blood pressure (SBP) or diastolic blood pressure (DBP).

Nonrenal indications for continuous renal replacement therapy: A report from the Prospective Pediatric Continuous Renal Replacement Therapy Registry Group.

Objective: Continuous renal replacement therapy is the most often implemented dialysis modality in the pediatric intensive care unit setting for patients with acute kidney injury. However, it also has a role in the management of patients with nonrenal indications such as clearance of drugs and intermediates of disordered cellular metabolism.

Measurements And Methods: Using data from the multicenter Prospective Pediatric Continuous Renal Replacement Therapy Registry, we report a cohort of pediatric patients receiving continuous renal replacement therapy for nonrenal indications.

Update on the pharmacologic treatment of hypertension in pediatrics.

J Clin Hypertens (Greenwich). 2012; 14:383-387. ©2012 Wiley Periodicals, Inc.

Incidence and treatment of hypertension in the neonatal intensive care unit.

The incidence and risk factors for hypertension in the neonatal intensive care unit (NICU) is inadequately defined, and the current utilization of antihypertensive medications in this specialized environment is not known. We evaluated the incidence of hypertension, associated risk factors, and utilization of antihypertensive drugs in the NICU using a large, geographically diverse pediatric database. A total of 123,847 NICU encounters were identified in the database.

Cisplatin pharmacokinetics in a child receiving peritoneal dialysis.

Cisplatin is a highly effective and frequently used drug in the chemotherapy of solid tumors in children, but there is currently no information to guide dosing in children requiring dialysis. Here, we present the case of a 2-year-old boy with end-stage renal disease managed with peritoneal dialysis and requiring cisplatin for a newly diagnosed hepatoblastoma. A pharmacokinetic study was performed to personalize the cisplatin dose with the goal of providing adequate cisplatin exposure and avoiding excessive exposure and toxicity.

Use of the multipurpose drainage catheter for the provision of acute peritoneal dialysis in infants and children.

Background: Prior experience with the Cook (Cook Inc, Bloomington, IN) Teflon rigid catheter (CTC) showed it to be a suboptimal access for acute peritoneal dialysis (PD) treatment in infants and children because of the frequency of catheter-related complications associated with its use. The objective of this study is to report our experience with the bedside-placed flexible Cook Mac-Loc Multipurpose Drainage catheter (CMMDC) for acute PD in critically ill infants, comparing it with the historic Tenckhoff catheter (TC) and CTC use.

Study Design: Retrospective cohort study.

Outcome of infants born to women with chronic kidney disease.

Pregnancy in women with chronic kidney disease is not uncommon and is not without risk to the mother and child. This article reviews the literature on the outcome of infants from pregnancies in women with chronic kidney disease (CKD), including those receiving dialysis and those living with a functional kidney transplant. Pregnancy in women with CKD and end-stage renal disease (ESRD) is associated with a higher rate of premature birth and small-for-gestational-age (SGA) infants, with resultant increase in neonatal mortality.

Vancomycin disposition following intraperitoneal administration in children receiving peritoneal dialysis.

Background: Little information is available on the disposition of vancomycin during chronic peritoneal dialysis (PD) in children. The primary objective of this study was to investigate the disposition of vancomycin following intraperitoneal (IP) administration in children receiving short-dwell [e.g.

Nephrotoxicity of over-the-counter analgesics, natural medicines, and illicit drugs.

Toxic nephropathy is a disorder whose primary feature is impairment of the normal functions of the kidney. The clinical manifestations of toxic nephropathy vary from a mild reduction in renal function to hematuria, proteinuria, and urolithiasis to a severe progressive toxicity culminating in end-stage renal disease. Although it is commonplace for adolescents to use supplemental treatments such as natural medicines and over-the-counter (OTC) analgesics, they do not often reveal the use of such treatments to physicians, nor do they fully understand their potential adverse effects.

Safety of the newer antihypertensive agents in children.

Hypertension is relatively uncommon in children and few children receive antihypertensive medications. This article reviews the safety of calcium channel blockers, angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists in children with hypertension. While the newer antihypertensive agents appear to be well-tolerated by children, further studies are needed to determine the safety profile across the developmental continuum, with chronic dosing and in children with complex hypertension.