Lausanne University Medical School, CHUV-1011, Lausanne, Switzerland.
Néonatologie, Réanimation Néonatale et Pédiatrique, CHU La Réunion, Site Sud, Saint Pierre, France.
Pediatr Nephrol. 2021 Sep;36(9):2687-2695. doi: 10.1007/s00467-021-04921-3. Epub 2021 Jan 22.
The use of diuretics is extremely frequent in sick neonates, the more so in very premature newborn infants. The use of diuretics in patients whose kidney function is immature necessitates a thorough knowledge of renal developmental physiology and pathophysiology. This review presents the basic aspects of body fluid homeostasis in the neonate, discusses the development of kidney function, and describes the mechanisms involved in electrolyte and water reabsorption along the nephron. Diuretics are then classified according to the site of their action on sodium reabsorption. The use of diuretics in sodium-retaining states, in oliguric states, in electrolyte disorders, and in arterial hypertension, as well as in a few specific disorders, is presented. Common and specific adverse effects are discussed. Recommended dosages for the main diuretics used in the neonatal period are given. New developments in diuretic therapy are briefly mentioned.
利尿剂在患病新生儿中被广泛应用，早产儿中更为常见。在肾功能不成熟的患者中使用利尿剂需要深入了解肾脏发育的生理学和病理生理学。这篇综述介绍了新生儿体液平衡的基本方面，讨论了肾功能的发育，并描述了沿肾单位进行电解质和水重吸收的机制。然后根据利尿剂在钠重吸收部位的作用对其进行分类。本文介绍了利尿剂在保钠状态、少尿状态、电解质紊乱和动脉高血压中的应用，以及在一些特定疾病中的应用。讨论了常见和特定的不良反应。给出了新生儿期常用利尿剂的推荐剂量。简要提及了利尿剂治疗的新进展。
