Evidence map›Paper›PMID 42174350›Full record

ReviewPharmaceutical research2026

Physiological and Anatomical Alterations in Children with Liver Cirrhosis.

Femke A Elzinga, Samira Lier, Paul R V Malik, Bart L Rottier, Onno W Akkerman, Henkjan J Verkade, Frank Bodewes, Daan J Touw, Paola Mian

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Review in Pharmaceutical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Femke A Elzinga *Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Samira Lier *Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Paul R V MalikIonis, Carlsbad, CA, USA.
Bart L RottierDepartment of Pediatric Pulmonology and Pediatric Allergology, University Medical Center Groningen, Beatrix Children's Hospital, University of Groningen, Groningen, the Netherlands.
Onno W AkkermanDepartment of Pulmonary Diseases and Tuberculosis, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
Henkjan J VerkadeDepartment of Pediatrics, Division of Pediatric Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Frank BodewesDepartment of Pediatrics, Division of Pediatric Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Daan J TouwDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Paola MianDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. p.mian@umcg.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate physiological and anatomical changes in children with liver cirrhosis supporting the development of physiologically based pharmacokinetic (PBPK) models.

methodsA literature review was conducted (December 2023-May 2024) using PubMed and Google Scholar to identify studies reporting physiological and anatomical parameters in children (< 18 years) with liver cirrhosis. Parameters were analyzed in relation to disease severity (Child-Pugh and/or MELD/PELD scores), stratified by age, and compared to adult data. This study examined parameters modified in adult liver cirrhosis PBPK models to assess if similar changes occur in children.

resultsParameters such as albumin, α1-acid glycoprotein, glomerular filtration rate, functional liver mass, portal blood flow, hepatic arterial blood flow, renal blood flow, and cardiac index showed either comparable alterations or lacked sufficient pediatric data to confirm differences from adult data. Hematocrit was significantly lower in children aged 2 to < 6 years (P = 0.022), with up to 25% greater fractional decline compared to adults, possibly due to developmental and nutritional factors.

conclusionWhile children with liver cirrhosis exhibit physiological trends similar to adults, hematocrit shows a clear age-specific difference. For other parameters, limited pediatric data prevents firm conclusions, highlighting the need for age-specific studies to improve PBPK models and guide pediatric drug therapy.

Indexed as

LiverLiver CirrhosisModels, BiologicalAdolescentAge FactorsChildChild, PreschoolHematocritHumansInfantSeverity of Illness Indexliver cirrhosispediatricsphysiologically based pharmacokinetic modeling

Identifiers

PMID42174350
PMCPMC13350154

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