Renal response to vasopressin in premature infants: what is new?

Clinical and experimental data indicate that the neonatal pituitary is capable of responding with arginine vasopressin (AVP) release to physiological stimulation and pathological events commonly seen in the perinatal period. The limited concentrating performance of the newborn kidney is thought, therefore, to be accounted for by the diminished end-organ responsiveness to AVP and the inability of the immature kidney to generate and maintain deep corticopapillary osmotic gradient. Evidence has been provided to indicate that in low birth weight premature infants the impaired renal tubular sodium transport, the renal salt wasting and late hyponatremia, and the increased renal prostaglandin production may be important factors in attenuating renal response to AVP.