A study of the renin-angiotensin system in newborn infants

Kotchen, Theodore A.; Strickland, Alva L.; Rice, Thomas W.; Walters, Douglas R.

doi:10.1016/s0022-3476(72)80005-2

Cited by 152 publications

(78 citation statements)

References 34 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: 72%

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: 72%

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

Matsuoka¹,

Shibao²,

Leone³

2007

Sao Paulo Med. J.

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“…Due to an increased urinary sodium loss in premature infants their renin-angiotensin-Aldo axis is markedly elevated (14)(15)(16). High urinary levels of tetrahydroaldosterone suggest renal tubular unresponsiveness of Aldo (17,18).…”

Section: Discussionmentioning

confidence: 99%

Plasma Mineralocorticoids, Glucocorticoids, and Progestins in Premature Infants: Longitudinal Study during the First Week of Life

et al. 1988

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ABSTRACT. Plasma levels of aldosterone, corticosterone, 11-deoxycorticosterone, progesterone, 17-hydroxyproge.sterone, 11-deoxycortisol, cortisol, and cortisone were measured simultaneously by a micromethod of multisteroid analysis in eight vaginally delivered premature infants (PI) of 33-36 wk gestation with uneventful peri-and postnatal course. Mean concentrations (nglml) in umbilical arterial and in peripheral venous or capillary plasma sampled longitudinally at age 2 h to 7 days were compared with the same kind of data obtained from a group of 12 term infants (TI) who served as controls. Mean aldosterone was two to five times higher in PI than in TI (umbilical artery, 2 h to 7 days; p < 0.05), whereas 11-deoxycorticosterone was lower in PI from 2 h ( p < 0.01) until 7 days (NS).Corticosterone was significantly higher in PI than TI at 6 and 24 h after birth, whereas cortisol was slightly lower (NS) in PI in umbilical artery and 2 h after birth, but higher (p c 0.02) at 6 h, showing less variation in PI than in TI. 17-Hydroxyprogesterone levels in PI were two to three times higher ( p c 0.02) during 6 h until 7 days after birth. The data suggest that PI are able to maintain high aldosterone levels in the early neonatal period. Higher levels of the active glucocorticoids (cortisol and corticosterone) seen after delivery point to a more stressful extrauterine adaptation of PI. Furthermore, the data demonstrate that the adrenal cortex is fully functioning in premature infants (33-36 wk gestation) as well as in term infants. (Pediatr Res 23: 525-529,1988) Abbreviations RDS, respiratory distress syndrome UA, umbilical artery Aldo, aldosterone DOC, 11-deoxycorticosterone E, cortisone S, 11-deoxycortisol B, corticosterone F, cortisol P. progesterone 170HP, 17-hydroxyprogesterone Abrupt cessation of steroid supply from the placenta after severing the umbilical cord, and rapid postnatal involution of the fetal zone of the adrenal cortex dramatically changes the hormonal milieu of the fetus after birth. There is increasing evidence that the adrenal cortex plays an important role in the postnatal adaptation of newborns (1). For full-term healthy infants, data on plasma steroid levels in the neonatal period are available (2, 3), but studies on adrenal steroids in healthy premature infants are still lacking. Our micromethod of multisteroid analysis (4, 5) enabled us to measure simultaneously in a single small plasma sample individual mineralocorticoids, glucocorticoids, and progestins in premature infants at birth and longitudinally during the first hours and days of life.Herein we assess in detail the adrenocortical function of healthy moderately premature infants after birth and provide reference data for the physiologically most important corticosteroids. MATERIALS AND METHODSEight premature appropriate for gestational age infants (33-36 wk gestation) of both sexes (three males, five females) with uneventful peri-and postnatal courses were studied longitudinally from birth to day 7. Their mothers (20-36 yr) were heal...

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“…PRA declined in association with the onset of puberty, resulting in a significant increase in the proportion of subjects with low PRA within 5 years. In normal childhood the opposite occurs: PRA declines with age from high levels in the newborn 19 to lesser levels between infancy and 4 years of age and reaches adult levels by 9-10 years of age. 2021 These levels continue until a final decline occurs in the forties.…”

Section: Discussionmentioning

confidence: 98%

Plasma renin activity and albumin excretion in teenage type I diabetic subjects. A prospective study.

et al. 1989

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Plasma renin activity (PRA) may be high among teenage and young adult insulin-dependent diabetic subjects. Supine PRA and stimulated PRA were therefore measured in 50 female and 50 male diabetic subjects, 13-20 years old, diagnosed before the age of 16. Fifty percent have been restudied after 4.6±0.2 (mean±SEM) years. Initially, 43% had high PRA (supine 4.0±0.37, stimulated 12.02±0.8 ng/ml/hr angiotensin I), 45% had normal activity (supine 2.89±0.26, stimulated 6.47±0.34 ng/ml/hr/angiotensin I), and 12% had low activity (supine 1.57±0.05, stimulated 3.09±0.08 ng/ml/hr/angiotensin I). Levels were directly associated with prepubertal duration of diabetes and were inversely associated with duration of diabetes after onset of puberty but not with total duration or patient age. E levated albumin excretion rates (AER) at rest or during exercise are reported as evidence of early nephropathy. 12 The time course for progression to clinical nephropathy, indicated by persistent proteinuria, is highly variable. In subjects who develop insulin-dependent diabetes before the age of 16, nephropathy is extremely rare before 16 years of age and does not occur before 10-15 years after onset of disease; the cumulative risk for diabetic nephropathy is between 33 and 40%. 34 Current evidence points to increased intrarenal pressure as underlying the initiation and progression of diabetic nephropathy.5 However, factorsFrom the

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A study of the renin-angiotensin system in newborn infants

Cited by 152 publications

References 34 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

Plasma Mineralocorticoids, Glucocorticoids, and Progestins in Premature Infants: Longitudinal Study during the First Week of Life

Plasma renin activity and albumin excretion in teenage type I diabetic subjects. A prospective study.

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