Jose P A, Fildes R D
Department of Pediatrics, Georgetown University Medical Center, Washington, DC, USA.
Mead Johnson Symp Perinat Dev Med. 1988(33):71-6.
Renal function in the newborn is both qualitatively and quantitatively different from older infants, children and adults. Moreover, gestational age is of great importance in the interpretation of renal functional differences. These differences in renal function should not be viewed as solely immaturity per se but rather as functional adaptations to the needs of growth and development in many instances. Although the neonatal kidney is operating at a level appropriate for a given age, the decreased functional reserve makes it more vulnerable to stressful conditions. However, the low GFR and some of the decreased transport properties may actually be of benefit to the neonate. With respect to medications, one benefit of these neonatal differences appears to be less nephrotoxicity for certain drugs in the newborn compared with the adult.
新生儿的肾功能在质和量上都与较大的婴儿、儿童及成人不同。此外,胎龄在解释肾功能差异方面非常重要。这些肾功能差异不应仅仅被视为本身的不成熟,而在许多情况下应被视为对生长发育需求的功能适应。尽管新生儿的肾脏在给定年龄的水平上运作,但功能储备的降低使其更容易受到应激条件的影响。然而,低肾小球滤过率和一些转运特性的降低实际上可能对新生儿有益。就药物而言,这些新生儿差异的一个好处似乎是与成人相比,某些药物对新生儿的肾毒性较小。