The effects of large volume intravenous fluid infusion on neonatal renal function

Postnatal Changes in Proximal and Distal Tubular Sodium Reabsorption in Healthy Very-Low-Birth-Weight Infants

“…This suggests that the various studies are comparable. It is interesting to note that at 1 week of postnatal age mean distal tubular Na delivery in our study is about one third of the mean value for the high fluid volume group but similar to that of the low fluid vol ume group in the study of Leake et al [1], suggesting that proximal tubular Na reab sorption is being overestimated throughout the study. Comparability of our results with those in the longitudinal study of Sulyok et al [2] suggests that this overestimation is probably consistent throughout the study pe riod.…”

“…it will overestimate proximal tubular Na reabsorption. It has been shown previously that maximal values for Ch,o are not achieved until urine volume exceeds 15-20 ml/min/dl glomerular filtration rate [1,7], In both the present and previous neonatal stud ies mean values for urine volume expressed in relation to glomerular filtration rate have generally been below the aforementioned level. We chose not to induce a water diure sis with a hypotonic saline load to ensure maximal urinary dilution in our infants be cause such fluid intakes may predispose VLBW infants to development of potentially serious complications such as a persistently patent ductus arteriosus or necrotizing en terocolitis [13].…”

“…However, when our data are expressed in the forms used by Leake et al [ 1 ] and Sulyok et al [2. 3], mean estimates of distal tubular Na delivery are similar for our infants and those in the afore mentioned studies at similar postnatal ages.…”

“…Previous studies have suggested that deficiencies in both proximal and distal tu bular sodium reabsorption contribute to the natriuresis [1][2][3]. The marked improvement in estimated efficiency of distal tubular func tion shown to occur during the first 2-3 weeks has been considered by many to be the major factor resulting in improved sodium conservation.…”

Glucose Infusions into Peripheral Veins in Neonates with Hypoglycemia

“…However, 10% and even 15% glucose infusions increase fluid load especially in patients, who need high glucose intakes to reach sufficient energy intake or to maintain normal plasma glucose levels. Although large fluid volumes of short duration are well tolerated in neonates (Leake, et al, 1976), the effect of continuous rapid infusions on the fluid clearance have not been determined. First voiding might be delayed due to elevated Arginine vasopressin levels in newborn infants delivered vaginally after a prolonged and stressful labor (Vuohelainen T et al, 2007 and2008).…”