Plasma Renin Activity and Its Postnatal Development in Preterm Infants

Richer, Christine; Hornych, Helena; Amiel‐Tison, Claudine; Relier, Jean-Pierre; Giudicelli, Jean‐François

doi:10.1159/000240979

Cited by 63 publications

(23 citation statements)

References 13 publications

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“…This result had already been described in the literature. [24][25][26] Blood pressure levels did not correlate with PRA levels (at birth and on the 30 th day), in either group. These results concord with other authors' results, 27,28 in which no such correlation was also found.…”

Section: Discussionmentioning

confidence: 74%

Blood pressure and kidney size in term newborns with intrauterine growth restriction

Matsuoka¹,

Shibao²,

Leone³

2007

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Low birth weight is associated with higher blood pressure in childhood and adulthood. The aim of this study was to investigate the influence of intrauterine growth restriction (IUGR) on newborn systolic blood pressure (SBP). DESIGN AND SETTING: Prospective comparative study at Neonatal and Intensive in Clinical Pediatrics Division, Maternity Hospital in Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. METHODS: 35 newborns with IUGR and 35 without IUGR were compared. Healthy term newborns without malformations, with Apgar score at fifth minute > 6 were included. Birth weight, kidney weight/birth weight ratio, kidney weight (ultrasound scan), plasma renin activity (PRA) and SBP evolution were analyzed during the first month of life (on 1st, 3rd, 7th and 30th days). RESULTS: SBP evolution, kidney weight/birth weight ratio and PRA did not differ between the two groups. In newborns with IUGR, SBP presented positive correlations with birth weight (r = 0.387 p = 0.026) and BMI (r = 0.412 p = 0.017) on the 7th day of life. Positive correlations with birth weight (r = 0.440 p = 0.01) and birth length (r = 0.386 p = 0.026) were also seen on the 30th day. There was an inverse correlation on the 7th day between SBP and kidney weight/birth weight ratio (r = -0.420 p = 0.014), but this did not persist to the end of the month. CONCLUSIONS: IUGR seems not to have any influence on SBP, PRA or kidney weight among term newborns during their first month of life.

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Section: Discussionmentioning

confidence: 74%

Blood pressure and kidney size in term newborns with intrauterine growth restriction

Matsuoka¹,

Shibao²,

Leone³

2007

Sao Paulo Med. J.

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“…In a preliminary study on postnatal development of PRA in four preterm infants by Richer et al (22), PRA was found to be very high in the 2-3 weeks and it decreased thereafter. Neither PRA in the first 2 weeks, nor electrolyte balance and aldosterone status were determined in the study (22).…”

Section: Discussionmentioning

confidence: 90%

“…Neither PRA in the first 2 weeks, nor electrolyte balance and aldosterone status were determined in the study (22).…”

Section: Discussionmentioning

confidence: 99%

Postantal Development of Renin-Angiotensin-Aldosterone System, RAAS, in Relation to Electrolyte Balance in Premature Infants

et al. 1979

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Summarycharacteristic for hypoaldosteronism, it is tempting to postulate a causal relationship between physiologic hyponatremia and the In an attempt to provide information about the role of RAAS in function of renin-angiotensin-aldoster~ne system (RAAS) in low development of late hyponatremia in low-birthweight neonates, birthweight neonate.simultaneous measurement of plasma renin activity, (PRA),In an attempt to obtain information about the role of RAAS in plasma aldosterone concentration (PA), and urinary aldosterone development of hyponatremia, the present study was undertaken excretion (UAE) was made using RIA methods along with deter-to determine the postnatal changes of plasma renin activity (PRA), mination Na and weekly to the 6th week of life' plasma aldosterone concentration (PA), and urinary aldosterone Seven healthy male infants with mean birthweight of 1580 g, range: excretion (UAE) in relation to the electrolyte balance in premature 1160-1850 g, and mean gestational age of 31 weeks, range: 30-32 infants during the first 6 weeks of life. weeks, were selected for the study.Due to the increased urinary Na loss, negative Na balance developed in the first 2 weeks followed by positive balance there- MATERIALS A N D METHODSafter. PRA, PA, and UAE increased tremendously from the initially high values of 18.2 f 4-1 ng/ml/hr, 1.7 f 0.5 and 2.6The studies were performed on seven healthy male appropriate f 0.4 %/day, mean and SEM, to their maximum of 78.6 18e1 for dates premature infants. The mean birthweight and the gesng/ml/hr, P < 0.01,6-8 f 3.7 ng/ml, P < 0-05, and 26.4 f 2.9 tational age of the infants was 1580 g and 31 weeks with the day, P < 0.01, in the 3rd week, respectively. Later on, gradual ranges of 1160-1850 g and 30-32 weeks, respectively. The mothers declines occurred, however, PRA, PA, and UAE remained highly were on normal diet without diuretic therapy, none had a history elevated even at the 6th week with values of 45.5 +-15 ng/ml/hr, of renal disease or previous toxemia of pregnancy. All undenvent 1.6 f 0.5 ng/ml, and 14.5 + 1.4 &day, respectively. uncomplicated vaginal delivery. Gestational age was assessed It is suggested that late h~ponatremia of Premature infants is primarily from the mothers menstrual history, but was confirmed due to tubular unresponsiveness to aldosterone and not to in&-by physical examination of the infant. The l-min Apgar score was quate response of RAAS to stimulation. more than 7 and the perinatal course remained uneventful in each case. SpeculationThe infants were fed appropriate cow's milk formulas ("RobCbi A") by a round the clock feeding pattern at 2-hourly intervals The initially high urinary sodium excretion in premature infants until they weighed about 1500 g and 3-hourly intervals, thereafter. is coupled with low urinary potassium excretion indicating limited The formula contained 71 calories, 2.1 g protein, 3.4 g fat, 8.0 g renal sodium reabsorption in exchange for potassium. Later on, sugar, and 0.5 g minerals in 100 ml. Food intake was gradually progre...

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“…After the clinical development of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, the interest in the renin-angiotensin system weaned. This probably explains why our extensive literature search only identified 7 studies that reported on PRA in preterm 9,10,12 or full-term 7,8,10,11 born children. PRA peaks in the healthy newborns and falls with aging reaching mean values similar to those in adults around 8 years of age.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] For the timely prevention of kidney disease, diagnosing hypertension and renal dysfunction early in life are of primordial importance. To the best of our knowledge, only 6 former studies in preterm or full-term born children reported on plasma renin activity (PRA) [7][8][9][10][11][12] or addressed the potential role of renin in the pathogenesis of hypertension. 10,12 To bridge knowledge gaps, we undertook the PREMATCH case-control study (Prematurity as Predictor of Children's Cardiovascular and Renal Health).…”

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confidence: 99%

Does Extremely Low Birth Weight Predispose to Low-Renin Hypertension?

et al. 2017

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Abstract-Low birth weight and prematurity are risk factors for hypertension in adulthood. Few studies in preterm or fullterm born children reported on plasma renin activity (PRA). We tested the hypothesis that renin might modulate the incidence of hypertension associated with prematurity. We enrolled 93 prematurely born children with birth weight <1000 g and 87 healthy controls born at term, who were all examined at ≈11 years. Renal length and glomerular filtration rate derived from serum cystatin C were 0.28 cm (95% confidence interval, 0.09-0.47) and 11.5 mL/min per 1.73 m 2 (6.4-16.6) lower in cases, whereas their systolic/diastolic blood pressure (BP) was 7.5 mm Hg (4.8-10.3)/4.0 mm Hg (2.1-5.8) higher (P<0.001 for all). The odds of having systolic prehypertension or systolic hypertension associated with extreme low birth weight were 6.43 (2.52-16.4; P<0.001) and 10.9 (2.46-48.4; P=0.002). Twenty-four hours of urinary sodium excretion was similar in cases and controls (102.1 versus 106.8 mmol; P=0.47). Sodium load per nephron was estimated as sodium excretion divided by kidney length (mmol/cm). PRA was 0.54 ng/mL per hour (0.23-0.85; P=0.001) lower in cases. PRA, systolic BP, and sodium load were available in 43 cases and 56 controls. PRA decreased with systolic BP (slope −0.022 ng/ mL per hour/ −mm Hg ; P=0.048), but was unrelated to sodium load (slope +0.13 mmol/cm −mm Hg ; P=0.54). The slope of PRA on systolic BP was similar (P=0.17) in cases and controls. In conclusion, extremely low birth weight predisposes young adolescents to low-renin hypertension, but does not affect the inverse association between PRA and BP. Clinical Trial Registration-URL: https://www.clinicaltrials.gov. Unique identifier: NCT02147457.

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Plasma Renin Activity and Its Postnatal Development in Preterm Infants

Cited by 63 publications

References 13 publications

Blood pressure and kidney size in term newborns with intrauterine growth restriction

Blood pressure and kidney size in term newborns with intrauterine growth restriction

Postantal Development of Renin-Angiotensin-Aldosterone System, RAAS, in Relation to Electrolyte Balance in Premature Infants

Does Extremely Low Birth Weight Predispose to Low-Renin Hypertension?

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