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The Role of Aldosterone on the Development of Renal Tubular Reabsorption in Low Birth Weight Infants

Journal of the Korean Pediatric Society 2001;44(11):1233-1242.
Published online November 15, 2001.
The Role of Aldosterone on the Development of Renal Tubular Reabsorption in Low Birth Weight Infants
Byung Min Choi1, Hoe Kyoung Koo1, Jin Won Yook1, Kyoung Bum Kim1, Gi Young Jang2, Moon Hee Kim3, Kee Hwan Yoo3, Young Sook Hong3, Joo Won Lee3, Soon Kyum Kim3
1Department of Pediatrics, College of Medicine, Kwandong University, Seoul, Korea
2Department of Pediatrics, College of Medicine, Inje University, Seoul, Korea
3Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
저출생 체중아에서 신세뇨관 재흡수능의발달에 따른 Aldosterone의 역할
최병민1, 구희경1, 육진원1, 김경범1, 장기영2, 김문희3, 유기환3, 홍영숙3, 이주원3, 김순겸3
1관동대학교 의과대학 소아과학교실
2인제대학교 의과대학 소아과학교실
3고려대학교 의과대학 소아과학교실
Correspondence: 
Byung Min Choi, Email: CBMin@hitel.net
Abstract
Purpose
: To determine the postnatal changes in aldosterone action on the renal tubular reabsorption in low birth weight(LBW) infants, we assessed the relation of the aldosterone concentrations to renal parameters during the first 10 days of life.
Methods
: Twenty LBW infants were evaluated and their gestational ages ranged from 32.4 to 39.3 weeks and their birth weights ranged from 1,440 to 2,500 g. Estimated glomerular filtration rate, fractional excretion of sodium(FENa) and potassium(FEK), and plasma aldosterone concentrations were analyzed according to the postnatal age and the conceptional age(CA).
Results
: Glomerular functions were improved after birth and were correlated with CA. FENa and FEK decreased after birth and correlated with CA. Plasma aldosterone concentrations increased to 318.6?47.2 ng/dL at 48 hours and then decreased to 162.0?2.2 ng/dL at 10 days after birth. Plasma aldosterone concentrations of infants less than 38th week of CA were higher than that of infants more than 38th week. There was a significant negative correlation coefficient between plasma aldosterone concentrations and FENa in infants more than 34th week of CA, but not in that of less than 34th week.
Conclusion
: LBW infants have higher plasma aldosterone concentrations, but a poor correlation between plasma aldosterone concentration and urinary sodium excretion for the first few days of life and in lower chronologic aged infants. These results show that the renal tubule reabsorption of sodium is less responsive to plasma aldosterone in these infants and, therefore, the careful management of fluid and electrolyte balance is mandatory.
Key Words: Plasma aldosterone, Low birth weight infant, Fractional excretion of sodium, Fractional excretion of potassium, Renal tubular function


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