Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1992 Oct;67(10 Spec No):1140–1145. doi: 10.1136/adc.67.10_spec_no.1140

Renal function in sick very low birthweight infants: 1. Glomerular filtration rate.

B H Wilkins 1
PMCID: PMC1590468  PMID: 1444546

Abstract

A total of 135 measurements of polyfructoside clearance as a measure of glomerular filtration rate (GFR) were made in 39 infants of 25.5-33 weeks' gestation, birth weight 720-2000 g, between the ages of 0.5 and 33 days. GRF was related to postconceptional age and increased exponentially from geometric mean 0.59 ml/min at 26 weeks' postconceptional age to 1.40 ml/min at 33 weeks. GFR in the first week and GFR at later ages were the same for a given postconceptional age. GFR was the same in sick infants with severe ventilatory failure as in less ill infants. There was no evidence that GFR was influenced by nitrogen input. GFR increases postnatally in a preprogrammed way irrespective of other postnatal events. When factored by body weight GFR in the first week increased only little from arithmetic mean 0.70 ml/min/kg at 26 weeks to 0.84 ml/min/kg at 33 weeks, but older infants often had a falsely high GFR per kg when they lost weight in the first week or two after birth or failed to gain weight later.

Full text

PDF
1140

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Al-Dahhan J., Haycock G. B., Chantler C., Stimmler L. Sodium homeostasis in term and preterm neonates. I. Renal aspects. Arch Dis Child. 1983 May;58(5):335–342. doi: 10.1136/adc.58.5.335. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Arant B. S., Jr Developmental patterns of renal functional maturation compared in the human neonate. J Pediatr. 1978 May;92(5):705–712. doi: 10.1016/s0022-3476(78)80133-4. [DOI] [PubMed] [Google Scholar]
  3. Arant B. S., Jr Estimating glomerular filtration rate in infants. J Pediatr. 1984 Jun;104(6):890–893. doi: 10.1016/s0022-3476(84)80488-6. [DOI] [PubMed] [Google Scholar]
  4. Beguin F., Dunnihoo D. R., Quilligan E. J. Effect of carbon dioxide elevation on renal blood flow in the fetal lamb in utero. Am J Obstet Gynecol. 1974 Jul 1;119(5):630–637. doi: 10.1016/0002-9378(74)90124-0. [DOI] [PubMed] [Google Scholar]
  5. Bhakoo O. N., Scopes J. W. Weight minus extracellular fluid as metabolic reference standard in newborn baby. Arch Dis Child. 1971 Aug;46(248):483–489. doi: 10.1136/adc.46.248.483. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Brion L. P., Fleischman A. R., McCarton C., Schwartz G. J. A simple estimate of glomerular filtration rate in low birth weight infants during the first year of life: noninvasive assessment of body composition and growth. J Pediatr. 1986 Oct;109(4):698–707. doi: 10.1016/s0022-3476(86)80245-1. [DOI] [PubMed] [Google Scholar]
  7. CORT R. L. Renal function in the respiratory distress syndrome. Acta Paediatr. 1962 May;51:313–323. doi: 10.1111/j.1651-2227.1962.tb06546.x. [DOI] [PubMed] [Google Scholar]
  8. Cole B. R., Giangiacomo J., Ingelfinger J. R., Robson A. M. Measurement of renal function without urine collection. A critical evaluation of the constant-infusion technic for determination of inulin and para-aminohippurate. N Engl J Med. 1972 Nov 30;287(22):1109–1114. doi: 10.1056/NEJM197211302872202. [DOI] [PubMed] [Google Scholar]
  9. Coulthard M. G. Comparison of methods of measuring renal function in preterm babies using inulin. J Pediatr. 1983 Jun;102(6):923–930. doi: 10.1016/s0022-3476(83)80026-2. [DOI] [PubMed] [Google Scholar]
  10. Coulthard M. G., Hey E. N. Weight as the best standard for glomerular filtration in the newborn. Arch Dis Child. 1984 Apr;59(4):373–375. doi: 10.1136/adc.59.4.373. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Coulthard M. G. Maturation of glomerular filtration in preterm and mature babies. Early Hum Dev. 1985 Sep;11(3-4):281–292. doi: 10.1016/0378-3782(85)90082-9. [DOI] [PubMed] [Google Scholar]
  12. Gouyon J. B., Guignard J. P. Functional renal insufficiency: role of adenosine. Biol Neonate. 1988;53(4):237–242. doi: 10.1159/000242796. [DOI] [PubMed] [Google Scholar]
  13. Guignard J. P., Torrado A., Da Cunha O., Gautier E. Glomerular filtration rate in the first three weeks of life. J Pediatr. 1975 Aug;87(2):268–272. doi: 10.1016/s0022-3476(75)80600-7. [DOI] [PubMed] [Google Scholar]
  14. Guignard J. P., Torrado A., Mazouni S. M., Gautier E. Renal function in respiratory distress syndrome. J Pediatr. 1976 May;88(5):845–850. doi: 10.1016/s0022-3476(76)81129-8. [DOI] [PubMed] [Google Scholar]
  15. Herin P., Zetterström R. Studies in renal response to various protein intakes in preterm infants. Acta Paediatr Scand. 1987 May;76(3):447–452. doi: 10.1111/j.1651-2227.1987.tb10497.x. [DOI] [PubMed] [Google Scholar]
  16. Joppich R., Häberle D. A., Weber P. C. Studies of the immaturity of the ADH-dependent cAMP system in conscious newborn piglets--possible impairing effects of renal prostaglandins. Pediatr Res. 1981 Mar;15(3):278–281. doi: 10.1203/00006450-198103000-00015. [DOI] [PubMed] [Google Scholar]
  17. Keen D. V., Pearse R. G. Weight, length, and head circumference curves for boys and girls of between 20 and 42 weeks' gestation. Arch Dis Child. 1988 Oct;63(10 Spec No):1170–1172. doi: 10.1136/adc.63.10_spec_no.1170. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Leake R. D., Trygstad C. W., Oh W. Inulin clearance in the newborn infant: relationship to gestational and postnatal age. Pediatr Res. 1976 Aug;10(8):759–762. doi: 10.1203/00006450-197608000-00013. [DOI] [PubMed] [Google Scholar]
  19. Modi N., Hutton J. L. The influence of postnatal respiratory adaptation on sodium handling in preterm neonates. Early Hum Dev. 1990 Jan;21(1):11–20. doi: 10.1016/0378-3782(90)90106-s. [DOI] [PubMed] [Google Scholar]
  20. Rees L., Brook C. G., Shaw J. C., Forsling M. L. Hyponatraemia in the first week of life in preterm infants. Part I. Arginine vasopressin secretion. Arch Dis Child. 1984 May;59(5):414–422. doi: 10.1136/adc.59.5.414. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Robillard J. E., Weismann D. N., Herin P. Ontogeny of single glomerular perfusion rate in fetal and newborn lambs. Pediatr Res. 1981 Sep;15(9):1248–1255. doi: 10.1203/00006450-198109000-00005. [DOI] [PubMed] [Google Scholar]
  22. Robillard J. E., Weitzman R. E., Burmeister L., Smith F. G., Jr Developmental aspects of the renal response to hypoxemia in the lamb fetus. Circ Res. 1981 Jan;48(1):128–138. doi: 10.1161/01.res.48.1.128. [DOI] [PubMed] [Google Scholar]
  23. Siegel S. R., Fisher D. A., Oh W. Renal function and serum aldosterone levels in infants with respiratory distress syndrome. J Pediatr. 1973 Nov;83(5):854–858. doi: 10.1016/s0022-3476(73)80389-0. [DOI] [PubMed] [Google Scholar]
  24. Stonestreet B. S., Bell E. F., Warburton D., Oh W. Renal response in low-birth-weight neonates. Results of prolonged intake of two different amounts of fluid and sodium. Am J Dis Child. 1983 Mar;137(3):215–219. doi: 10.1001/archpedi.1983.02140290007002. [DOI] [PubMed] [Google Scholar]
  25. Strauss J., Daniel S. S., James L. S. Postnatal adjustment in renal function. Pediatrics. 1981 Dec;68(6):802–808. [PubMed] [Google Scholar]
  26. Svenningsen N. W. Single injection polyfructosan clearance in normal and asphyxiated neonates. Acta Paediatr Scand. 1975 Jan;64(1):87–95. doi: 10.1111/j.1651-2227.1975.tb04383.x. [DOI] [PubMed] [Google Scholar]
  27. Torrado A., Guignard J. P., Prod'hom L. S., Gautier E. Hypoxaemia and renal function in newborns with respiratory distress syndrome (RDS). Helv Paediatr Acta. 1974 Nov;29(5):399–405. [PubMed] [Google Scholar]
  28. Tulassay T., Ritvay J., Bors Z., Büky B. Alterations in creatinine clearance during respiratory distress syndrome. Biol Neonate. 1979;35(5-6):258–263. doi: 10.1159/000241183. [DOI] [PubMed] [Google Scholar]
  29. Waugh W. H. Photometry of inulin and polyfructosan by use of a cysteine/tryptophan reaction. Clin Chem. 1977;23(4):639–645. [PubMed] [Google Scholar]
  30. Wilkins B. H. A reappraisal of the measurement of glomerular filtration rate in pre-term infants. Pediatr Nephrol. 1992 Jul;6(4):323–327. doi: 10.1007/BF00869724. [DOI] [PubMed] [Google Scholar]
  31. Wilkins B. H. Renal effects of theophylline in very low birthweight neonates. Contrib Nephrol. 1988;67:155–159. doi: 10.1159/000415394. [DOI] [PubMed] [Google Scholar]
  32. Wilkins B. H. Renal function in sick very low birthweight infants: 2. Urea and creatinine excretion. Arch Dis Child. 1992 Oct;67(10 Spec No):1146–1153. doi: 10.1136/adc.67.10_spec_no.1146. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Wilkins B. H. Renal function in sick very low birthweight infants: 3. Sodium, potassium, and water excretion. Arch Dis Child. 1992 Oct;67(10 Spec No):1154–1161. doi: 10.1136/adc.67.10_spec_no.1154. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES