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Fractional sodium excretion, urinary osmolality and specific gravity in preterm infants fed with fortified donor
Atsuko Tanaka1, Ligia M S S Rugolo, Antero F M Miranda
1Departamento de Pediatria, Faculdade de Medicina de Marília, Marília, SP, Brasil.
Insights
Fortifying donor human milk with nutrients did not adversely affect the renal function of premature infants. This study found no negative impacts on kidney function in preterm newborns receiving fortified human milk.
Area of Science:
- Neonatology
- Pediatric Nephrology
- Human Milk Research
Background:
- Premature infants require specialized nutrition.
- Donor human milk is an option, but fortification may be necessary.
- The renal effects of fortified donor milk in preterm infants are not fully understood.
Purpose of the Study:
- To investigate the renal effects of fortified donor human milk in premature newborn infants.
- To compare renal function parameters between infants receiving unfortified and fortified donor milk.
Main Methods:
- A clinical intervention trial with 28 premature infants (<34 weeks and >=34 weeks postconceptional age).
- Infants were assessed on unfortified and then fortified donor human milk over 10-13 days.
- Evaluated nutrient intake, weight gain, fractional sodium excretion, and urinary osmolality/specific density.
Main Results:
- Weight gain was satisfactory, with similar fluid, energy, and sodium intake between groups.
- Infants <34 weeks showed lower serum sodium and elevated fractional sodium excretion at study's end.
- Urinary osmolality and specific density remained normal, with no significant group differences.
Conclusions:
- Feeding premature infants fortified donor human milk showed no adverse effects on renal function.
- The study supports the safety of using fortified donor milk for preterm infant nutrition.
Objective:
This research was performed with the objective of investigating the renal effects on premature newborn infants of fortifying banked donor human milk.
Methods:
Clinical intervention trial, of the before-and-after type, involving 28 premature newborn infants split into two groups by postconceptional age at the start of the study: GI < 34 weeks (n = 14) and GII >or= 34 weeks (n = 14), and assessed at three sample points: S1, on unfortified donor human milk, S2, after 3 days, and S3, after 10-13 days on fortified donor human milk. Nutrient intake, weight gain, fractional sodium excretion, urinary osmolality and specific density were compared with two-way ANOVA for repeated measures.
Results:
Fluids, energy and sodium intakes were similar for both groups, and weight gain was satisfactory. Among the preterms with < 34 weeks postconceptional age, serum sodium was lower at the end of the study and the fractional sodium excretion was elevated at the start and at the end of the study (S1 = 2.11+/-1.05; S2 = 1.25+/-0.64; S3 = 1.62+/-0.88), with a significant difference in relation to GII (S1 = 1.34+/-0.94; S2 = 0.90+/-0.54; S3 = 0.91+/-0.82). Osmolality and urinary specific density were normal, with no differences between groups or collection dates.
Conclusions:
No adverse effects on the renal function of these preterms were detected as a result of being fed fortified donor human milk.
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