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Developmental patterns of renal functional maturation compared in the human neonate

B S Arant

    The Journal of Pediatrics
    |May 1, 1978
    PubMed

    Insights

    Human infant kidney function matures rapidly after 34 weeks gestational age (GA). Renal development in premature infants mirrors fetal development, closely linked to conceptional age.

    Area of Science:

    • Neonatal Physiology
    • Pediatric Nephrology
    • Human Development

    Background:

    • Extrauterine life significantly impacts neonatal physiological systems.
    • Renal functional maturation is a critical aspect of infant development.
    • Understanding renal adaptation in premature infants is essential for clinical care.

    Purpose of the Study:

    • To investigate the influence of extrauterine life on renal functional maturation in human newborns.
    • To correlate renal function parameters with conceptional age in premature infants.
    • To compare the pattern of renal development in premature infants with fetal development.

    Main Methods:

    • Serial renal function assessments in 49 newborns (25-41 weeks GA) within 48 hours of birth.
    • Longitudinal studies of 12 infants born at or before 34 weeks GA.
    • Measurement of glomerular filtration rate (GFR), glucosuria, tubular reabsorption of phosphate (TRP), and urinary alpha amino nitrogen.

    Main Results:

    • GFR was low before 34 weeks GA, increasing rapidly thereafter.
    • Glucosuria was common in infants ≤30 weeks GA.
    • Glomerulotubular balance for glucose was consistently observed.
    • Urinary alpha amino nitrogen excretion was highest in infants <34 weeks GA.
    • TRP decreased post-feeding with rising serum phosphate.

    Conclusions:

    • Renal functional development in human infants is strongly related to conceptional age (gestational age + postnatal age).
    • The pattern of renal functional development for premature infants during extrauterine life parallels that of fetuses in utero of similar conceptional age.
    • These findings highlight the importance of conceptional age in assessing neonatal renal function.

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