Effect of ammonium-chloride-induced metabolic acidosis on renal electrolyte handling in human neonates. 1990

E Sulyok, and J P Guignard
County Children's Hospital, Pécs, Hungary.

The present study was undertaken to determine the relative contribution of altered glomerular and tubular functions to the metabolic-acidosis-induced increase of renal electrolyte excretion in healthy preterm and full-term neonates and in older infants. Studies were performed in 10 premature infants (mean birth weight 1618 g, gestational age 30.8 weeks) weekly for 6 consecutive weeks, in 11 full-term neonates (mean birth weight 3085 g, gestational age 38.6 weeks) on the 7th day of life and in 25 older control infants (mean age 6.5 months, body weight 6802 g), before and after NH4Cl loading. Blood acid-base parameters, plasma and urine electrolyte and creatinine concentrations were measured, endogenous creatinine clearance and fractional electrolyte excretion (FE) calculated. It was demonstrated that the significant reduction in blood pH and total CO2 content induced by NH4Cl administration was associated with significant increases in glomerular filtration rate (GFR), urine flow rate, FENa and FECl, in each group studied, irrespective of maturity, postnatal age or pre load values. FEK also tended to increase, but the change reached statistical significance only in older infants and in premature babies during the 1st, 2nd and 5th week of post-natal life. FECa and FEPO4 increased slightly in preterm and full-term newborns and became significant in older infants. Prior to NH4Cl administration, FECa correlated positively with FENa in each group. NH4Cl metabolic acidosis, however, dissociated FECa from FENa in the full-term newborns and older infants but not in the preterm neonates.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007234 Infant, Premature A human infant born before 37 weeks of GESTATION. Neonatal Prematurity,Premature Infants,Preterm Infants,Infant, Preterm,Infants, Premature,Infants, Preterm,Premature Infant,Prematurity, Neonatal,Preterm Infant
D007668 Kidney Body organ that filters blood for the secretion of URINE and that regulates ion concentrations. Kidneys
D002245 Carbon Dioxide A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D004573 Electrolytes Substances that dissociate into two or more ions, to some extent, in water. Solutions of electrolytes thus conduct an electric current and can be decomposed by it (ELECTROLYSIS). (Grant & Hackh's Chemical Dictionary, 5th ed) Electrolyte
D005919 Glomerular Filtration Rate The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to INULIN clearance. Filtration Rate, Glomerular,Filtration Rates, Glomerular,Glomerular Filtration Rates,Rate, Glomerular Filtration,Rates, Glomerular Filtration
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000136 Acid-Base Equilibrium The balance between acids and bases in the BODY FLUIDS. The pH (HYDROGEN-ION CONCENTRATION) of the arterial BLOOD provides an index for the total body acid-base balance. Anion Gap,Acid-Base Balance,Acid Base Balance,Acid Base Equilibrium,Anion Gaps,Balance, Acid-Base,Equilibrium, Acid-Base,Gap, Anion,Gaps, Anion
D000138 Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are RESPIRATORY ACIDOSIS and metabolic acidosis, due to metabolic acid build up. Metabolic Acidosis,Acidoses,Acidoses, Metabolic,Acidosis, Metabolic,Metabolic Acidoses

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