Potassium metabolism in extremely low birth weight infants in the first week of life

Lorenz, John M.; Kleinman, Leonard I.; Markarian, Katherine

doi:10.1016/s0022-3476(97)70128-8

Cited by 91 publications

(67 citation statements)

References 14 publications

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“…When the plots are linearly extrapolated, the minimum potassium excretion is positive at day 0 and the regulatory potassium excretion capacity crosses the x-axis at 1.7 d. This suggests that the onset of the extra potassium excretion ability in the immature kidney may be as early as the second day of life. The result is consistent with the observation [10] that the mean plasma potassium concentration in ELBW infants decreased during the 2-3 d after birth when physiological diuresis begins.…”

Section: Discussionsupporting

confidence: 92%

“…[9] and of low-birthweight infants (0.038 Eq/h/g body wt.) [10]. This further indicates that kidney tubules in newborn rats reabsorb almost all filtrated potassium in spite of high PK, when potassium supplement was absent in stomach and intestine.…”

Section: Discussionmentioning

confidence: 84%

“…Lorenz et al [10] showed that hyperkalemia in ELBW was not associated with the renal dysfunction, but with a shift of potassium from the ICF to the ECF. This idea is good to explain a transient increase in PK without potassium intake, but it cannot explain the continuous high PK during the newborn period.…”

Section: Discussionmentioning

confidence: 99%

“…mal level after the onset of physiologic diuresis in the first 2-3 d of life [10]. Moreover, numerous papers have reported that newborn animals, such as infants [3], piglets [13], and dogs [9] can excrete the exogenous potassium load.…”

mentioning

confidence: 99%

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Development of Renal Potassium Excretion Capacity in the Neonatal Rat.

Anzai

Suzuki²,

Nishikitani³

et al. 2001

JJP

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Development of Renal Potassium Excretion Capacity in the Neonatal Rat.

Anzai

Suzuki²,

Nishikitani³

et al. 2001

JJP

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“…NOHK is a common finding in VLBW neonates, occurring in 30-50% of babies during the first 72 hours of life. 18,19 A study of 62 extremely low birth weight (ELBW) babies demonstrated no difference in peak potassium and insulin levels during the first 3 days in the EHAA group compared to the SAA group. 13 Our study revealed that NOHK was significantly less in the EPN group.…”

Section: Discussionmentioning

confidence: 99%

Early Versus Late Parenteral Nutrition in Very Low Birthweight Neonates : A Retrospective Study from Oman

Aroor¹,

Krishnan²,

Reyes³

et al. 2012

SQUMJ

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(EPN group, n = 44). Demographic data, anthropometric and laboratory parameters were extracted from the electronic record system. Results: The mean age of PN initiation was LPN = 47.3 hours versus EPN = 14.3 hours. Biochemical parameters analysed during the first week of life revealed a reduction in hypernatraemia (12.7% versus 6.8%) and non-oliguric hyperkalemia (12.7% versus 6.8%) in EPN, with no significant differences in acidosis and urea levels between the two groups. Hyperglycemia >12 mmol/L in <1000g was higher in EPN. Nutritional parameters in 81 babies who survived/stayed in the unit up to a corrected gestational age (CGA) of 34 weeks (40 in LPN and 41 in EPN), revealed a reduction in metabolic bone disease (osteopenia of prematurity [OOP], 17.5% versus 7.3%) and the need for phosphate supplementation (22.5% versus 7.3%) in the EPN group. There was no increase in acidosis or cholestasis. No difference was noted in albumin levels, time to full feeds, time to regain birthweight and mean weight gain per day till 34 weeks corrected CGA. Conclusion: EPN in VLBW newborns is well tolerated and reduces hypernatraemia, non-oliguric hyperkalemia, OOP and the need for phosphate supplementation. Early versus Late Parenteral Nutrition in VeryLow Birthweight Neonates A retrospective study from Oman 1 They are traditionally started on a dextrose infusion and graded to parenteral nutrition (PN) over several days. The goal of EPN is to provide an intravenous substrate that promotes protein deposition and increased lean body mass that approximates fetal growth rate and accretion. In recent years, early introduction and aggressive advancement of PN have been shown to be safe and effective.2,3 Protein delivery of 3 gm/kg beginning on day one (D1) of life is safe and associated with plasma AA concentrations similar to those of second and third trimester fetuses. 4 In the absence of iatrogenic causes of electrolyte and acid base derangements, significant individual variations in nutritional requirements of preterm neonates from PN are rare. 5 Hypothesising that premature infants might benefit from the anabolic effects of EPN without metabolic derangement, we investigated the benefits of EPN in VLBW neonates. The objectives of our study were to compare the following between the EPN and LPN groups: 1) Biochemical disturbances in the first week of life; 2) Weight gain/day, mean weight at 34 weeks corrected gestational age (CGA), time to full feeds and time to regain birth weight, and 3) Incidence of osteopenia, the need for phosphate supplementation, cholestasis and albumin levels. The study included all inborn VLBW babies between and including gestational age 25-32weeks and weighing ≤1500 g; those that survived >7days for assessing biochemical parameters; infants who survived/stayed in the NICU until corrected gestational age (CGA) of 34 weeks for assessing nutritional parameters, and who received PN for >5 days. Excluded from this study were infants with chromosomal and major congenital anomalies; those on PN for >4weeks; ba...

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Interventions for non-oliguric hyperkalaemia in preterm neonates

Vemgal¹,

Ohlsson²

2005

Cochrane Database of Systematic Reviews

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Potassium metabolism in extremely low birth weight infants in the first week of life

Cited by 91 publications

References 14 publications

Development of Renal Potassium Excretion Capacity in the Neonatal Rat.

Development of Renal Potassium Excretion Capacity in the Neonatal Rat.

Early Versus Late Parenteral Nutrition in Very Low Birthweight Neonates : A Retrospective Study from Oman

Interventions for non-oliguric hyperkalaemia in preterm neonates

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