Role of renin and aldosterone in establishment of electrolyte balance in very low birthweight neonates

Urine sodium, potassium and chloride excretion, plasma renin activity (PRA) and urine aldosterone excretion (UAE) were measured in seven very low birthweight (VLBW) infants during the first 6 weeks after birth. Hyponatraemia was most common, and major changes in urine electrolyte excretion occurred, during the first 2 weeks. These changes in urine electrolyte excretion appeared to relate to improvement in distal tubular function. PRA did not correlate with urine excretion of either aldosterone or electrolytes. However, UAE correlated significantly with fractional sodium‐potassium exchange in the distal tubule in a non‐linear fashion (P<0.001) which suggested a threshold of aldosterone responsiveness between 70 and 100 nmol/24 h per 1.73 m2 UAE. We conclude that in VLBW infants the distal tubule can respond to aldosterone during the first 2–3 weeks, but that the threshold for responsiveness appears to be higher than it is in fullterm infants

[1]  S. Siegel,et al.  Transplacental Transfer of Aldosterone and Its Effects on Renal Function in the Fetal Lamb , 1981, Pediatric Research.

[2]  R. David,et al.  Nutritional composition of milk produced by mothers delivering preterm. , 1980, The Journal of pediatrics.

[3]  W. Oh,et al.  Composition of breast milk obtained from mothers of premature infants as compared to breast milk obtained from donors. , 1980, The Journal of pediatrics.

[4]  R. Leake,et al.  Theophylline Increases Glomerular Filtration Rate in Preterm lnfants , 1980 .

[5]  E. Sulyok,et al.  On the mechanisms of renal sodium handling in newborn infants. , 1980, Biology of the neonate.

[6]  F. Smith,et al.  Role of aldosterone on renal sodium and potassium excretion during fetal life and newborn period. , 1980, Developmental Pharmacology and Therapeutics.

[7]  A. Aperia,et al.  SODIUM EXCRETION IN RELATION TO SODIUM INTAKE AND ALDOSTERONE EXCRETION IN NEWBORN PRE‐TERM AND FULL‐TERM INFANTS , 1979, Acta paediatrica Scandinavica.

[8]  E. Sulyok,et al.  Postnatal development of renal sodium handling in premature infants. , 1979 .

[9]  E. Sulyok,et al.  Relationship between maturity, electrolyte balance and the function of the renin-angiotensin-aldosterone system in newborn infants. , 1979, Biology of the neonate.

[10]  T. Ertl,et al.  Postantal Development of Renin-Angiotensin-Aldosterone System, RAAS, in Relation to Electrolyte Balance in Premature Infants , 1979, Pediatric Research.

[11]  E. Sulyok,et al.  POSTNATAL DEVELOPMENT OF RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM /RAAS/ IN RELATION TO ELECTROLYTE BALANCE IN PREMATURE INFANTS , 1979, Pediatric Research.

[12]  E. Wintour,et al.  Effect of aldosterone on urine composition in the chronically cannulated ovine foetus. , 1978, The Journal of endocrinology.

[13]  O. Smales,et al.  A study of factors affecting blood pressure and angiotensin II in newborn infants. , 1977, The Journal of pediatrics.

[14]  W. Jubiz,et al.  Potassium-renin-aldosterone relationships during the first year of life. , 1977, The Journal of pediatrics.

[15]  F. Girard,et al.  Plasma Aldosterone Concentrations during the Neonatal Period , 1977, Pediatric Research.

[16]  C. de Rouffignac,et al.  Renal clearance studies in fetal and young guinea pigs: effect of salt loading. , 1977, The American journal of physiology.

[17]  J. Honour,et al.  ALDOSTERONE AND SODIUM HOMEOSTASIS IN PRETERM INFANTS , 1977, Acta paediatrica Scandinavica.

[18]  C. Amiel‐Tison,et al.  Plasma Renin Activity and Its Postnatal Development in Preterm Infants , 1977 .

[19]  W. Oh,et al.  The effects of large volume intravenous fluid infusion on neonatal renal function. , 1976, The Journal of pediatrics.

[20]  J. Balfe,et al.  Electrolyte Abnormalities in Very Low Birthweight Infants , 1976, Pediatric Research.

[21]  D. Hill,et al.  Late Hyponatremia in Very Low Birthweight Infants (< 1.3 Kilograms) , 1976, Pediatric Research.

[22]  A. Salvetti,et al.  Methodological simplifications in radioimmunoassay of urinary aldosterone. , 1976, Clinica chimica acta; international journal of clinical chemistry.

[23]  W. Oh,et al.  Serum aldosterone concentrations related to sodium balance in the newborn infant. , 1974, Pediatrics.

[24]  W. Oh,et al.  Renal function and serum aldosterone levels in infants with respiratory distress syndrome. , 1973, The Journal of pediatrics.

[25]  E. Sulyok.  The relationship between electrolyte and acid-base balance in the premature infant during early postnatal life. , 1971, Biology of the neonate.

[26]  E. Haber,et al.  Application of a radioimmunoassay for angiotensin I to the physiologic measurements of plasma renin activity in normal human subjects. , 1969, The Journal of clinical endocrinology and metabolism.

[27]  J. Porush,et al.  Increased sodium reabsorption in the proximal and distal tubule of caval dogs. , 1969, The Journal of clinical investigation.

[28]  H. Mcnamara,et al.  Renal tubular response to aldosterone in normal infants and children with adrenal disorders. , 1967, The Journal of clinical endocrinology and metabolism.

[29]  R. Abramson,et al.  Effects of hypotonic saline loading in hydrated dog: evidence for a saline-induced limit on distal tubular sodium transport. , 1967, The Journal of clinical investigation.

[30]  H. M. Whyte,et al.  The measurement of creatinine in plasma and urine. , 1958, The Australian journal of experimental biology and medical science.

[31]  D. DuBois,et al.  A formula to estimate the approximate surface area if height and weight be known , 1989 .