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Lookup NU author(s): Dr Malcolm Coulthard
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Aims-To determine the extent of renal processing of glucose in sick and well neonates. Methods-Glomerular filtration rate (GFR) and the renal processing of glucose, sodium, and water were measured using prolonged inulin infusion in 47 infants of 26-40 weeks of gestation, aged 1-13 days. Results-GFR rose by 15% after ventilatory support was withdrawn, and was unaffected by clinical instability. Fractional glucose excretion was low in the stable unventilated babies except at very high filtered loads, but rose in one unstable, unventilated baby. It was higher in ventilated babies, and remained high for at least six days after ventilation. For water and sodium, net differences between intake and urine excretion were not affected by ventilation, clinical stability, or glycosuria. Conclusions-A combination of a low GFR and a high fluid intake, urine flow, and urine concentrating capacity, makes neonates very unlikely to develop an osmotic diuresis due to glycosuria while they have a blood glucose below 12 mmol/l, despite assertions to the contrary.
Author(s): Coulthard MG, Hey EN
Publication type: Article
Publication status: Published
Journal: Archives of Disease in Childhood Fetal & Neonatal Edition
Print publication date: 01/09/1999
ISSN (print): 1359-2998
Publisher: BMJ Group