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A symmetrically growth retarded premature infant was born to a mother with advanced diabetic nephropathy, chronic renal failure, and hypertension, and managed with aggressive medical therapy without the use of dialysis. The neonatal course was uncomplicated, except for cord blood creatinine and BUN concentrations of 4.7 mg/dl and 116 mg/dl, respectively, that fell to 1.1 mg/dl and 44 mg/dl by 2 days of age. Strict glucose control, careful management of the metabolic abnormalities of uremia, and periodic surveillance of fetal well-being led to a successful pregnancy.
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