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. 1985 Jul;60(7):614–620. doi: 10.1136/adc.60.7.614

Effect of varying water intake on renal function in healthy preterm babies.

M G Coulthard, E N Hey
PMCID: PMC1777266  PMID: 4026356

Abstract

Renal control of water and electrolyte homeostasis was studied in 10 healthy babies (gestation 29 to 34 weeks; birthweight 1.19 to 2.19 kg) while water intake was varied. Glomerular filtration rate and urine flow were estimated daily from spot plasma and urine samples for six days using a constant inulin infusion, and simultaneous sodium, potassium, osmolar, and free water clearances were calculated. The infusion was started at an average age of 14 hours. Each baby received a total fluid intake of 96 ml/kg daily on study days 1, 2, and 5, and about 200 ml/kg on study days 3, 4, and 6. Daily sodium intake was kept constant at 3 mmol/kg. At the end of the first study day the babies were undergoing a diuresis, but thereafter their estimated daily water balances remained stable regardless of intake. Glomerular filtration remained stable; alterations in urine flow reflected a change in the percentage of filtrate excreted. Plasma electrolytes and osmolality were stable throughout, and on study days 2 to 6 the urinary excretion rates of sodium, potassium, and other osmoles remained the same regardless of urine flow. The delivery of sodium to the distal tubule was estimated to be between 17 and 20% of the filtered load. Well preterm babies can cope with daily water intakes between 96 and 200 ml/kg from the third day of life.

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Selected References

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

  1. AMES R. G. Urinary water excretion and neurohypophysial function in full term and premature infants shortly after birth. Pediatrics. 1953 Sep;12(31):272–282. [PubMed] [Google Scholar]
  2. 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]
  3. Bell E. F., Warburton D., Stonestreet B. S., Oh W. Effect of fluid administration on the development of symptomatic patent ductus arteriosus and congestive heart failure in premature infants. N Engl J Med. 1980 Mar 13;302(11):598–604. doi: 10.1056/NEJM198003133021103. [DOI] [PubMed] [Google Scholar]
  4. Cornblath M., Forbes A. E., Pildes R. S., Luebben G., Greengard J. A controlled study of early fluid administration on survival of low birth weight infants. Pediatrics. 1966 Oct;38(4):547–554. [PubMed] [Google Scholar]
  5. 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]
  6. 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]
  7. Davies P. A., Davis J. P. Very low birth-weight and subsequent head growth. Lancet. 1970 Dec 12;2(7685):1216–1219. doi: 10.1016/s0140-6736(70)92180-x. [DOI] [PubMed] [Google Scholar]
  8. Elinder G., Aperia A., Herin P., Källskog O. Effect of isotonic volume expansion on glomerular filtration rate and renal hemodynamics in the developing rat kidney. Acta Physiol Scand. 1980 Apr;108(4):411–417. doi: 10.1111/j.1748-1716.1980.tb06552.x. [DOI] [PubMed] [Google Scholar]
  9. FRIIS-HANSEN B. Body water compartments in children: changes during growth and related changes in body composition. Pediatrics. 1961 Aug;28:169–181. [PubMed] [Google Scholar]
  10. Leake R. D. Perinatal nephrobiology: a developmental perspective. Clin Perinatol. 1977 Sep;4(2):321–349. [PubMed] [Google Scholar]
  11. Leake R. D., Zakauddin S., Trygstad C. W., Fu P., Oh W. The effects of large volume intravenous fluid infusion on neonatal renal function. J Pediatr. 1976 Dec;89(6):968–972. doi: 10.1016/s0022-3476(76)80612-9. [DOI] [PubMed] [Google Scholar]
  12. Lorenz J. M., Kleinman L. I., Kotagal U. R., Reller M. D. Water balance in very low-birth-weight infants: relationship to water and sodium intake and effect on outcome. J Pediatr. 1982 Sep;101(3):423–432. doi: 10.1016/s0022-3476(82)80078-4. [DOI] [PubMed] [Google Scholar]
  13. McCANCE R. A., NAYLOR N. J., WIDDOWSON E. M. The response of infants to a large dose of water. Arch Dis Child. 1954 Apr;29(144):104–109. doi: 10.1136/adc.29.144.104. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. McCANCE R. A., WIDDOWSON E. M. Normal renal function in the first two days of life. Arch Dis Child. 1954 Dec;29(148):488–494. doi: 10.1136/adc.29.148.488. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Rodriguez-Soriano J., Vallo A., Castillo G., Oliveros R. Renal handling of water and sodium in infancy and childhood: a study using clearance methods during hypotonic saline diuresis. Kidney Int. 1981 Dec;20(6):700–704. doi: 10.1038/ki.1981.199. [DOI] [PubMed] [Google Scholar]
  16. SMALLPEICE V., DAVIES P. A. IMMEDIATE FEEDING OF PREMATURE INFANTS WITH UNDILUTED BREAST-MILK. Lancet. 1964 Dec 26;2(7374):1349–1352. doi: 10.1016/s0140-6736(64)91152-3. [DOI] [PubMed] [Google Scholar]
  17. Stonestreet B. S., Rubin L., Pollak A., Cowett R. M., Oh W. Renal functions of low birth weight infants with hyperglycemia and glucosuria produced by glucose infusions. Pediatrics. 1980 Oct;66(4):561–567. [PubMed] [Google Scholar]
  18. Sulyok E., Varga F., Györy E., Jobst K., Csaba I. F. On the mechanisms of renal sodium handling in newborn infants. Biol Neonate. 1980;37(1-2):75–79. doi: 10.1159/000241258. [DOI] [PubMed] [Google Scholar]
  19. Thompson M. H., Stothers J. K., McLellan N. J. Weight and water loss in the neonate in natural and forced convection. Arch Dis Child. 1984 Oct;59(10):951–956. doi: 10.1136/adc.59.10.951. [DOI] [PMC free article] [PubMed] [Google Scholar]

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