Effect of Hypercapnic Acidosis on Renal Function in the Newborn Rabbit

Heijden, A. J. Van Den; Guignard, Jean‐Pierre

doi:10.1203/00006450-198608000-00020

Cited by 15 publications

(3 citation statements)

References 15 publications

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“…The observed changes in GFR in neonates with RDS and those needing artificial ventilation, reported in the literature, are probably due to a combination of negative influences: hypoxaemia, hypercapnia and variations in systemic blood pressure. As an example, we have shown in the newborn rabbit model a significant decrease in GFR related to acute hypercapnic acidosis [19].…”

Section: Discussionmentioning

confidence: 98%

Glomerular filtration rate in the preterm infant: the relation to gestational and postnatal age

et al. 1988

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In 41 preterm neonates with a gestational age (GA) varying from 27 to 36 weeks, glomerular filtration rate (GFR) was measured by means of the continuous inulin infusion technique. The reliability of the technique was confirmed. During postnatal development GFR was found to increase in two ways: firstly, an increase with advancing gestational age, associated with the increase in body weight (BW) [GFR (ml/min) = 0.15 X GA-3.20, r = 0.48, P = 0.0048]; secondly, a postnatal increase, being independent from increment in BW. An increase in GFR (ml/min.kg) from 0.88 +/- 0.23 to 1.18 +/- 0.28 was observed between day 4 and day 11 postnatally (P less than 0.008). This latter increase is probably associated with changes in renal haemodynamics. No significant influence of artificial ventilation on GFR could be demonstrated in preterm neonates.

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Section: Discussionmentioning

confidence: 98%

Glomerular filtration rate in the preterm infant: the relation to gestational and postnatal age

et al. 1988

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“…1). Hypercapnic acidosis, another consequence of a variety of respiratory disorders, including neonatal RDS, can cause renal vasoconstriction, thus contributing to the overall renal dysfunction seen in severe asphyxia [41].…”

Section: Hypoxemiamentioning

confidence: 99%

The stressed neonatal kidney: from pathophysiology to clinical management of neonatal vasomotor nephropathy

Tóth-Heyn¹,

Drukker

Guignard

2000

Pediatric Nephrology

191

115

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The healthy term, and particularly the premature infant, is born with a very low glomerular filtration rate (GFR), controlled by a delicate balance of intrarenal vasoconstrictor and vasodilator forces. Vasoactive disturbances can easily further reduce the already low GFR. The newborn infant is thus prone to develop vasomotor nephropathy (VMNP) or acute renal failure (ARF). The main causes for ARF at this young age are prerenal mechanisms, and include hypotension, hypovolemia, hypoxemia perinatal asphyxia, and neonatal septicemia. Other causes include the administration of angiotensin converting enzyme inhibitors, indomethacin and tolazoline. The most-important factors governing the ultimate renal prognosis are the severity of the underlying disorder, the rapidity of an accurate diagnosis, prompt treatment, and avoidance of severe iatrogenic complications. The immediate treatment is of particular importance in VMNP, i.e., prerenal ischemic ARF, and consists of correcting abnormalities in fluid homeostasis and reduction of the complications of the acute azotemic state (uremia, hyperkalemia, acidosis, and hypertension). In severe and prolonged (established) ARF, temporary dialysis therapy may be indicated. Prerenal ARF with oliguria or anuria warrants immediate volume resuscitation. Special attention should be given to infants with congestive heart failure (CHF). The sick neonate with persistent oliguria and CHF should be treated with intravenous dopamine. Furosemide (FM) is the second line of therapy for babies with indomethacin-induced ARF. In most other conditions, the therapeutic effect of FM is limited to a transient increase in urine flow, without improving basic renal function. The special conditions of the maturing kidney have to be appreciated in order to protect babies from undue renal injury. With the increasing knowledge of the mechanisms governing the development of ARF, progress has been made in the development of new treatment modalities. For example theophylline, calcium antagonists, ATP-MgCl2, thyroxine, and a variety of cytokines may in the near future be used to prevent or ameliorate VMNP and/or recently established ARF. With a combination of time-honored and new therapeutic strategies, there may well be a brighter future for neonates with vasomotor, prerenal, ischemic ARF.

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“…After completion of the surgical procedure priming doses of inulin (100 mg/kg) and PAH (1.25 mg/kg) were administered and a sustained infusion was given to maintain constant plasma inulin and PAH concentrations. The infusion rate was 1 m1/100 g/h using a constant infusion pump (Perfusor EDL 2, Braun, Melsungen, Germany stable for Up to 3 h in this animal preparation (7,8).…”

Section: Methodsmentioning

confidence: 99%

Renal Effects of Theophylline and Caffeine in Newborn Rabbits

Gouyon

Guignard

1987

Pediatr Res

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ABSTRACT. Renal hemodynamics and functions were assessed in four groups of anaesthetized newborn rabbits receiving a single intravenous dose of methylxanthines, i.e.:aminophylline: 3 mg/kg (Al) or 6 mg/kg (A2); sodium benzoate caffeine: 5 mg/kg (Cl) or 10 mg/kg (C2). Each animal acted as its own control. The mean PAH extraction ratio was not modified by the methylxanthines. Renal blood flow and glomerular filtration rate were determined by clearances of paraaminohippuric acid and inulin, respectively. No changes in renal hemodynamics or renal functions were observed in group Cl. In group C2, renal blood flow and filtration fraction did not vary significantly but renal vascular resistance showed a delayed increase. Systemic infusion of the two aminophylline regimens induced a delayed increase in renal vascular resistance with a concomitant fall in renal blood flow and an increase of filtration fraction in group A2. Glomerular filtration rate was either reduced (3 mg/kg aminophylline) or increased (6 mg/kg aminophylline and 10 mg/kg caffeine). Moreover, diuresis increased and tubular water reabsorption declined in groups Al, A2, and C2. High dose caffeine enhanced sodium fractional excretion. The acute renal effects of methylxanthines appeared dose-and time-related in immature animals and caffeine proved safer than aminophylline at doses used in human neonates. (Pediatr Res 21: 615-618,1987) Abbreviations V, urine flow rate GFR, glomerular filtration rate MBP, mean blood pressure RBF, renal blood flow RVR, renal vascular resistance FF, filtration fraction FENa, sodium fractional excretion PAH, para-aminohippuric acid Hct, hematocrit E PAH, renal PAH extraction ratio U/P.inulin, urine to plasma inulin ratio MX, methylxanthine PG, prostaglandinThe xanthine derivatives theophylline and caffeine are widely used and equally effective to control idiopathic apnea in pre-

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Effect of Hypercapnic Acidosis on Renal Function in the Newborn Rabbit

Cited by 15 publications

References 15 publications

Glomerular filtration rate in the preterm infant: the relation to gestational and postnatal age

Glomerular filtration rate in the preterm infant: the relation to gestational and postnatal age

The stressed neonatal kidney: from pathophysiology to clinical management of neonatal vasomotor nephropathy

Renal Effects of Theophylline and Caffeine in Newborn Rabbits

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