Sex Differences on the Pharmacokinetics of Drugs for Children with Chronic Kidney Disease: A Narrative Review

Abstract

Abstract Purpose Effective optimal pharmacotherapy requires a comprehensive understanding of the drug’s pharmacokinetic properties. Whether sex differences exist in the pharmacokinetics of drugs for children with chronic kidney disease (CKD) is unknown. This article aims to address the many important factors that influence drug disposition and effects relative to age in children with chronic kidney disease (CKD). Method Electronic databases, PubMed, EMBASE, Google Scholar, and Web of Science were searched from inception, using Mesh terms in English for sex differences in the pharmacokinetics of drugs in children with chronic kidney disease (CKD). Results Evidence to date suggests that girls generally have a higher prevalence and disease progression of CKD when compared to boys. No studies documented sex-related differences in the pharmacokinetics of drugs for the treatment of CKD in children. As a consequence, it is difficult to predict the impact of CKD on pharmacokinetics by extrapolating data from adult studies in children. Conclusion The lack of pharmacokinetic studies in children with CKD makes it very difficult to predict the optimum therapeutic dosing. Future studies in the pharmacokinetics and pharmacodynamics of drugs are urgently needed to individualize therapeutic dosing for children with CKD.