POSTNATAL-DEVELOPMENT OF RENAL-FUNCTION DURING THE 1ST YEAR OF LIFE
POSTNATAL-DEVELOPMENT OF RENAL-FUNCTION DURING THE 1ST YEAR OF LIFE
复制标题
DOI：
10.1007/bf00849229
复制
发表时间：
1987-07-01
影响因子：
3
通讯作者：
ARANT, BS
中科院分区：
文献类型：
--
作者：
ARANT, BS
在生命的第一年，肾功能的几个方面变化很大，与成年人的等效值有明显差异。在婴儿达到34周的胎龄之前，肾小球滤过率（GFR）几乎没有增加，从肾脏发育的绝对GFR （ml/min）逐渐增加到青春期线性生长完成时的成熟值。经体型校正的GFR直到12个月后才能与成人正常值相比较；因此，无论GFR是通过定时收集尿液测量的Scror来估计的，对于婴儿来说，没有一个容易回忆的正常值范围。我们必须了解正常婴儿在出生后的第一年发生的肾功能变化。尽管多次尝试这样做，肾功能在第一年的生活不能通过尿流量评估。尿流率低于每小时1ml /kg可能是正常和适当的，可能对GFR正常的早产儿或足月婴儿无害。除了最极端的情况外，新生儿肾脏的集中能力受损可能在所有情况下都没有临床意义，也不是婴儿脱水、高钠血症或急性肾损伤风险增加的主要因素。婴儿的酸碱状态必须适当地解释，以知道何时应该引入碱治疗，以避免继发于代谢性酸中毒的生长衰竭。当测量高血压肾衰竭婴儿的血浆肾素活性时，必须将结果与正常婴儿出生后年龄的正常值范围进行比较。
Several aspects of renal function varyconsiderably during the 1st year of life and differ markedly from the equivalent values in the adult. Glomerular filtration rate (GFR) increases little, prior to the time an infant reaches a conceptional age of 34 weeks, the point in renal development from which the absolute GFR (ml/min) increases gradually to mature values when linear growth is completed during adolescence. GFR corrected for body size is not comparable with adult normal values until after 12 months of age; therefore, whether GFR is estimated from Scror measured by timed urine collection, there is no easily recalled range of normal values for infants. One must know the changes in the renal function of normal infants that take place following birth during the 1st year of life. Despite several attempts to do so, renal function during the 1st year of life cannot be assessed from urine flow rate. A urine flow rate of less than 1 ml/kg per hour may be normal and appropriate and may not be harmful either to preterm or full-term infants with normal GFR. Impaired concentrating ability of the neonatal kidney is probably of no clinical significance in all but the most extreme circumstances and is not a major factor in an infant becoming dehydrated, developing hypernatremia or being at greater risk of acute renal injury. Acid-base status in infants must be interpreted appropriately to know when alkali therapy should be introduced to avoid growth failure secondary to true metabolic acidosis. When plasma renin activity is measured in the infant with renal failure of hypertension, one must compare the result with the normal range of values related to postnatal age of normal infants.