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Neonatal acid base balance and disturbances

Raymond Quigley1, Michel Baum

  • 1Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9063, USA.

Seminars in Perinatology
|June 18, 2004
PubMed

Insights

Neonates face challenges maintaining acid-base balance due to metabolic acid production and immature kidney function. This review explores renal acid excretion mechanisms, their development, and inherited disorders in infants.

Area of Science:

  • Nephrology
  • Neonatal Physiology
  • Biochemistry

Background:

  • Growing neonates require protein, leading to acid production from sulfur-containing amino acid metabolism.
  • Bone mineralization (hydroxyapatite formation) also contributes to acid production in infants.
  • Neonates must excrete 2-3 mEq of acid/kg/day to prevent acidosis.

Purpose of the Study:

  • To review renal mechanisms for acid excretion in neonates.
  • To discuss the developmental regulation of these acid-base balance processes.
  • To explain the basis of inherited disorders affecting neonatal acidification.

Main Methods:

  • Review of existing literature on renal acid-base physiology in neonates.
  • Analysis of developmental changes in kidney acid-secreting mechanisms.
  • Examination of genetic factors contributing to neonatal acidosis.

Main Results:

  • Neonatal kidney acid excretion mechanisms undergo complex maturation.
  • Premature neonates are at higher risk for acidosis due to immature renal function.
  • Gastrointestinal disturbances can cause bicarbonate loss, necessitating renal compensation.

Conclusions:

  • The neonatal kidney plays a critical role in acid-base balance through acid excretion and bicarbonate production.
  • Developmental immaturity and inherited disorders pose significant risks for neonatal acidosis.
  • Understanding these mechanisms is crucial for managing acid-base disturbances in infants.

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