Abstract
Summary: Inulin clearance (Cin) was measured in 20 infants of 27–43 weeks of gestation during the First 24 hr of their extrauterine life. Cin ranged from 0.7–4.7 ml/min and correlated with gestational age (P < 0.05). In 18 infants of similar gestational ages studied after 2–3 days of extrauterine adaptation, the Cin ranged from 1.1–17.9 ml/min and also correlated with gestational age (P < 0.01). By day 2–3, the infants of near term gestational age achieved a greater increase in Cin than did the markedly preterm infants, as reflected by a significantly different slope of the regression line for Cin and gestational age for the infants studied at 1 vs. 2–3 days of age (P < 0.001).
Speculation: Although gestational age does affect glomerular fitration rate (GFR) in the first day of life, additional factors influencing glomerular filtration rate during this period may be adjustments in extratenal hemodynamics, renal blood flow, and extracellular volume. We have shown previously that high rates of infusion of fluid result in an increase in glomerular filtration rate in the preterm infant. It is possible that the limitation noted in glomerular filtration rate during the first few days of life is partly related to decreasing extracellular fluid.
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Leake, R., Trygstad, C. Glomerular Filtration Rate during the Period of Adaptation to Extrauterine Life. Pediatr Res 11, 959–962 (1977). https://doi.org/10.1203/00006450-197709000-00005
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DOI: https://doi.org/10.1203/00006450-197709000-00005
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