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Maturational changes in sodium metabolism in periviable infants

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Abstract

Background

Sodium depletion results in impaired somatic growth. The sodium requirements of extremely preterm (periviable) infants early in life are not known. We therefore investigated sodium homeostasis in this population over the first 10 weeks following birth.

Methods

This was a longitudinal, observational study of sodium intake and urine sodium excretion in a convenience cohort of 23 infants born at 22 0/7–23 6/7-week gestation.

Results

Sodium intake ranged from 5.2 ± 0.4 to a maximum of 7.9 ± 0.5 mEq/kg/day at 2 and 8 weeks of postnatal age, respectively, while urinary sodium loss was 7.7 ± 1.0 mEq/kg/day and 6.9 ± 0.7 mEq/kg/day at these time points. Sodium balance (sodium intake – urine sodium output) was first positive at 6 weeks of age, though a positive sodium balance exceeding 1.4 mEq/kg/day (i.e., a balance associated with weight gain of 30 g/day) was not observed until 10 weeks.

Conclusions

Infants born at 22–23-week gestational age have a prolonged period of high urinary losses of sodium and negative sodium balance. Sodium intakes greater than those currently recommended by the American Academy of Pediatrics are needed to achieve a significant positive sodium balance in this population.

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  • 06 November 2021

    ESM was extended to include the article's Graphical abstract

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Acknowledgements

The authors wish to acknowledge Mendi Schmelzel, MSN-RN, RNC-NIC, and Karen Johnson, RN BSN, for their assistance in gathering data and the families of our NICU patients for participating in this project.

Funding

No funding source or sponsorship supported original collection of data; however, JL Grobe is now supported by grants from the NIH (HL134850, HL084207), the American Heart Association (18EIA33890055), the MCW Clinical & Translational Science Institute “Obesity” Ensemble (UL1TR001436), and the Advancing a Healthier Wisconsin Endowment to MCW.

Author information

Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Medical College of Wisconsin, 999 North 92nd St, Suite C410, Milwaukee, WI, 53226, USA

    Jeffrey L Segar & Connie C Grobe

  2. Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, USA

    Jeffrey L Segar & Justin L Grobe

  3. Comprehensive Rodent Metabolic Phenotyping Core, Medical College of Wisconsin, Milwaukee, WI, USA

    Justin L Grobe

  4. Dept of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, USA

    Justin L Grobe

  5. Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA

    Justin L Grobe

  6. Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, USA

    Justin L Grobe

Authors
  1. Jeffrey L Segar
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  2. Connie C Grobe
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  3. Justin L Grobe
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Contributions

JS is responsible for conceptualizing the study, methodology, data curation, and analysis and wrote the initial draft of the manuscript. CG participated in data analysis and interpretation and in revising the draft manuscript. JG contributed to study methodology, data curation, and analysis and in revising the draft manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Jeffrey L Segar.

Ethics declarations

Ethics approval

Approval for this longitudinal cohort study was approved by the University of Iowa Human Subjects Institutional Review Board.

Consent to participate

Informed consent was obtained for parents of subjects according to Institutional Review Board policies.

Conflict of interest

The authors declare no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

J Segar and J Grobe were affiliated with the University of Iowa at the time the data were collected.

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Segar, J.L., Grobe, C.C. & Grobe, J.L. Maturational changes in sodium metabolism in periviable infants. Pediatr Nephrol 36, 3693–3698 (2021). https://doi.org/10.1007/s00467-021-05119-3

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  • DOI: https://doi.org/10.1007/s00467-021-05119-3

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