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Renal function in small for gestational age preterm infants.

Hany Aly1, Zahraa Ez El Din2, Reem M Soliman2

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Small for gestational age (SGA) preterm infants show compromised glomerular function compared to appropriate for gestational age (AGA) infants. Tubular function remains comparable between the two groups.

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Area of Science:

  • Neonatal physiology
  • Pediatric nephrology

Background:

  • Preterm infants, particularly those small for gestational age (SGA), face unique physiological challenges.
  • Understanding renal function in these vulnerable infants is crucial for clinical management.

Purpose of the Study:

  • To compare glomerular and tubular kidney functions in preterm infants categorized as small for gestational age (SGA) versus appropriate for gestational age (AGA).

Main Methods:

  • A prospective controlled study involving 50 preterm infants (320/7 to 366/7 weeks gestation).
  • Infants received gentamicin within the first 72 hours of life.
  • Glomerular and tubular functions were assessed on postnatal days 1 and 5.

Main Results:

  • On day 1, SGA infants exhibited higher serum sodium, serum urea, and urinary creatinine levels.
  • By day 5, SGA infants showed a significant increase in serum creatinine (p=0.04).
  • Urinary N-acetyl-beta-glucosaminidase (NAG) and fractional excretion of sodium (FeNa) were similar between SGA and AGA groups on both days.

Conclusions:

  • Glomerular function is impaired in preterm infants who are small for gestational age.
  • Tubular function appears to be comparable between SGA and AGA preterm infants during the early neonatal period.