Division of Neonatology, Department of Pediatrics, University Hospital Agostino Gemelli, Catholic University Sacred Heart, Rome, Italy.
Neonatology. 2009;96(3):171-4. doi: 10.1159/000210090. Epub 2009 Mar 31.
Increased activity of the renin-angiotensin-aldosterone system (RAAS) has been reported in the neonatal period. Until now, it has been demonstrated that the RAAS of healthy neonates responds to acute furosemide challenge while no data concerning the responsiveness of RAAS in extremely low birth weight (ELBW) infants are available.
To assess urinary aldosterone excretion (UAE) and renal function in ELBW infants who received diuretics for the purpose of reducing the incidence of chronic lung disease (CLD).
Infants with birth weights < or =1,000 g, at high risk to develop CLD, were studied in a prospective observational study. UAE and renal function were investigated before and after administration of furosemide given in a single dose of 2 mg/kg.
UAE and renal function were evaluated in 20 ELBW infants. Diuretic administration resulted in a significant rise in UAE and urinary sodium, potassium and chloride excretion. No change occurred in creatinine clearance, while urine volume increased significantly.
ELBW infants respond to acute furosemide challenge by increasing urine volume, urinary electrolytes and UAE.
已有研究报道，在新生儿期，肾素-血管紧张素-醛固酮系统（RAAS）的活性增加。迄今为止，人们已经证实健康新生儿的 RAAS 对速尿的急性刺激有反应，但尚无极低出生体重（ELBW）婴儿 RAAS 反应性的数据。
评估接受利尿剂治疗以降低慢性肺疾病（CLD）发生率的 ELBW 婴儿的尿醛固酮排泄量（UAE）和肾功能。
对出生体重≤1000g、有发生 CLD 高风险的婴儿进行前瞻性观察性研究。在给予 2mg/kg 的单剂量速尿后，检测 UAE 和肾功能。
对 20 例 ELBW 婴儿进行了 UAE 和肾功能评估。利尿剂的应用导致 UAE 和尿钠、钾、氯排泄量显著增加。肌酐清除率无变化，而尿量显著增加。
ELBW 婴儿通过增加尿量、尿电解质和 UAE 对急性速尿刺激有反应。
