Renal Aspects of Sodium Metabolism in the Fetus and Neonate

Sulyok, E.

doi:10.1016/b978-1-4160-3163-5.50008-7

Cited by 4 publications

(3 citation statements)

References 165 publications

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“…Transition to the extra-uterine environment is associated with physiological changes of body water composition consisting in isotonic fluid loss, mainly from the extracellular compartment (Sulyok, 2008). In very preterm infants, the first days of life are associated with high transcutaneous evaporative water losses and reduced ability of the kidney to concentrate urine, potentially leading to dehydration and hypernatremia (Agren et al, 1998;Gawlowski et al, 2006;Wada et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

The effect of parenteral nitrogen and energy intake on electrolyte balance in the preterm infant

et al. 2011

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Background/Objectives: Recent guidelines for preterm parenteral nutrition (PN) recommend an earlier and higher intake of amino acids (AA) and energy to avoid postnatal catabolism and approximate normal fetal growth. Few investigations explored how early PN may affect electrolyte and water homeostasis. We performed a prospective observational trial to assess the effect of nutrient intake on electrolyte homeostasis and balance. Subjects/Methods: During 16 months, all infants p32 weeks were eligible. In the first week of life, we recorded the following daily: electrolytes (plasma and 8-h urine collection), nutritional intake, urine output, body weight, and we calculated sodium (Na) and potassium (K) balance. Infants were divided, for analysis, into three groups of AA intake: low o1.5 g/kg/day (LAA), medium 1.5-2 g/kg/day (MAA) and high 42 g/kg/day (HAA). Results: A total of 154 infants were included. HAA group presented lower weight loss. Na balance was influenced by urine output and postnatal age, with little contribution of nutrition. Kalemia and K balance were mainly influenced by AA intake. K balance differed among groups: LAA, À2.3 mmol/kg/week; MAA, 1.1 mmol/kg/week; and HAA 2.6 mmol/kg/week (Po0.0001). In the HAA group, plasma and urine K were significantly lower and non-oliguric hyperkalemia was reduced. Conclusions: Na homeostasis was very slightly modified by early nutrition, suggesting that a negative Na balance is obligatory after birth. We showed that AA intake strongly affects K balance, minimize hyperkalemia and reduces weight loss. As K balance is strictly linked to cellular metabolism, we speculate that early nutrition may inhibit cellular catabolism and reduce the contraction of intracellular water compartment.

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Section: Introductionmentioning

confidence: 99%

The effect of parenteral nitrogen and energy intake on electrolyte balance in the preterm infant

et al. 2011

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“…The physiologically induced weight loss after birth is also due to the loss of sodium and water through the kidneys and thus a loss of extracellular fluid [11,12]. The weight loss in premature babies is up to 15%, in term babies around 10% [13,14]. However, this is not seen as dehydration, but as a physiological adaptation to extrauterine life.…”

Section: Introductionmentioning

confidence: 99%

Postpartum severe hyponatremia in preterm birth and mature newborns: Dangers for mother and child?

Felix¹,

Kunzmann²,

Mouzakiti³

et al. 2021

J Case Rep Images Obstet Gynecol

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Introduction: Sodium is the ion with the highest extracellular concentration and thus also determines the osmolality in the extracellular space. The lower the serum sodium, the more serious the dilemma.Case Series: Case 1: A eutrophic female was born at 37+3 weeks gestation, birth by vacuum extraction, birth weight 2570-gram, umbilical cord blood gas analysis performed in delivery showed severe hyponatremia (sodium 122 mmol/L). Case 2: A eutrophic male was born at 40+4 weeks gestation, spontaneous labor, birth weight 3230-gram, suspicion of cerebral seizure, postpartum hyponatremia, perinatal metabolic acidosis, respiratory failure, and hypoxic ischemic encephalopathy. Case 3: A eutrophic male was born at 38+4 weeks gestation, spontaneous birth, birth weight 2895-gram, postpartum severe hyponatremia, suspicion of cerebral seizure, cyanosis attacks. Case 4: A preterm female was born at 31+1 weeks gestation, birth weight 1195-gram, sodium 125 mmol/L, potassium 6.3 mmol/L with respiratory disorder. Conclusion:We recommend a quick diagnosis and stop the factors that cause hyponatremia. Laboratory

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“…Transition to the extrauterine environment is associated with major changes of body water and salt composition in the premature baby [1]. Changes in plasma sodium concentrations have been particularly studied, and large variations in sodium levels have shown a relationship with impaired outcome [2].…”

Section: Introductionmentioning

confidence: 99%

Chloride Balance in Preterm Infants during the First Week of Life

Iacobelli

Kermorvant‐Duchemin

Bonsante

et al. 2012

International Journal of Pediatrics

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Objective. To describe the chloride balance in infants born 25–32-week gestation, analyze the association of chloride changes with hydroelectrolytic status and their relationship with perinatal conditions, morbidities, and neurological outcome. Methods. For 7 days after birth, sodium and chloride balance, plasma potassium, phosphate, and total carbon dioxide (tCO2) were prospectively determined and strong ion difference (SID) calculated. Three multivariate regression analyses were performed to identify factors associated with high plasma chloride concentration, low SID, and low tCO2. Results. 107 infants were studied. Plasma chloride concentration was significantly positively associated with plasma sodium concentration. Higher plasma chloride and lower SID were significantly associated with lower plasma tCO2. Chloride intake was the main independent factor associated with high plasma chloride, low SID, and low plasma tCO2, with lesser contribution of sodium intake and low gestational age (GA). Also, patent ductus arteriosus and birth weight loss were independent factors affecting plasma chloride and SID. Neither high chloride levels nor low SID were associated to impaired neurological outcome. Conclusions. In preterm infants, chloride balance is influenced by GA and by interrelationship between sodium and chloride intake. High chloride levels are associated with metabolic acidosis but not related to increased risk of impaired neurological outcome.

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Renal Aspects of Sodium Metabolism in the Fetus and Neonate

Cited by 4 publications

References 165 publications

The effect of parenteral nitrogen and energy intake on electrolyte balance in the preterm infant

The effect of parenteral nitrogen and energy intake on electrolyte balance in the preterm infant

Postpartum severe hyponatremia in preterm birth and mature newborns: Dangers for mother and child?

Chloride Balance in Preterm Infants during the First Week of Life

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