Skip to main content

Approach to Renal Disease in the Neonate

  • Reference work entry
  • 249 Accesses

The transition from fetal to postnatal life requires dramatic physiologic adaptation by many organ systems: the kidneys must suddenly completely assume the role provided by the placenta in maintaining neonatal homeostasis. The pediatrician must recognize that in the full term infant, the kidney is programmed for this transition with an initial diuresis and natriuresis followed in several days by avid sodium retention, which is necessary for normal growth. While these responses were formerly regarded as “limitations” of the immature kidney, they are physiologically appropriate. However, because the neonate has an attenuated renal response to acute volume expansion compared to the older child, the composition and rate of administration of fluids and electrolytes must be carefully monitored. In the preterm infant, renal function reflects a developmental stage adapted to fetal rather than extrauterine life and glomerular and tubular function are even more restricted. Identification of...

Keywords

  • Acute Kidney Injury
  • Angiotensin Converting Enzyme Inhibitor
  • Renal Vein Thrombosis
  • Urinary Tract Obstruction
  • Congenital Nephrotic Syndrome

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-642-02202-9_289
  • Chapter length: 7 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   1,099.99
Price excludes VAT (USA)
  • ISBN: 978-3-642-02202-9
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Hardcover Book
USD   1,199.99
Price excludes VAT (USA)

References

  • Abitbol CL, Chandar J, Rodriguez MM, Berho M, Seeherunvong W, Freundlich M, Zilleruelo G (2009) Obesity and preterm birth: additive risks in the progression of kidney disease in children. Pediatr Nephrol 24:1363–1370

    PubMed  CrossRef  Google Scholar 

  • Adeniran AJ, Stanek J (2007) Amnion nodosum revisited: clinicopathologic and placental correlations. Arch Pathol Lab Med 131:1829–1833

    PubMed  Google Scholar 

  • Aksu N, Yavascan O, Kangin M, Kara OD, Aydin Y, Erdogan H, Tuncel TC, Cetinkaya E, Ozbay E, Sandikcioglu TG (2005) Postnatal management of infants with antenatally detected hydronephrosis. Pediatr Nephrol 20:1253–1259

    PubMed  CrossRef  Google Scholar 

  • Anderson N, Clautice-Engle T, Allan R, Abbott G, Wells JE (1995) Detection of obstructive uropathy in the fetus: predictive value of sonographic measurements of renal pelvic diameter at various gestational ages. Am J Roentgenol 164:719–723

    CrossRef  CAS  Google Scholar 

  • Askenazi DJ, Griffin R, McGwin G, Carlo W, Ambalavanan N (2009) Acute kidney injury is independently associated with mortality in very low birthweight infants: a matched case-control analysis. Pediatr Nephrol 24:991–997

    PubMed  CrossRef  Google Scholar 

  • Bacchetta J, Harambat J, Dubourg L, Guy B, Liutkus A, Canterino I, Kassai B, Putet G, Cochat P (2009) Both extrauterine and intrauterine growth restriction impair renal function in children born very preterm. Kidney Int 76:445–452

    PubMed  CrossRef  Google Scholar 

  • Bueva A, Guignard JP (1994) Renal function in preterm neonates. Pediatr Res 36:572–577

    PubMed  CrossRef  CAS  Google Scholar 

  • Chevalier RL (1998) What are normal potassium concentrations in the neonate? What is a reasonable approach to hyperkalemia in the newborn with normal renal function? Semin Nephrol 18:360–361

    PubMed  CAS  Google Scholar 

  • Chevalier RL (2001) The moth and the aspen tree: sodium in early postnatal development. Kidney Int 59:1617–1625

    PubMed  CrossRef  CAS  Google Scholar 

  • Chevalier RL (2004) Response to nephron loss in early development. In: Polin RA, Fox WW, Abman SH (eds) Fetal and neonatal physiology. W.B. Saunders, Philadelphia, pp 1330–1335

    CrossRef  Google Scholar 

  • Chevalier RL, Roth JA (2006) Renal function in the fetus, neonate and child. In: Wein AJ, Kavoussi LR, Novick AC et al (eds) Campbell-Walsh urology. Elsevier, Philadelphia, pp 3149–3162

    Google Scholar 

  • Clark DA (1977) Times of first void and first stool in 500 newborns. Pediatrics 60:457–459

    PubMed  CAS  Google Scholar 

  • Clautice-Engle T, Anderson NG, Allan RB, Abbott GD (1995) Diagnosis of obstructive hydronephrosis in infants: comparison sonograms performed 6 days and 6 weeks after birth. Am J Roentgenol 164:963–967

    CrossRef  CAS  Google Scholar 

  • Cohen HL, Cooper J, Eisenberg P, Mandel FS, Gross BR, Goldman MA, Barzel E, Rawlinson KF (1991) Normal length of fetal kidneys: sonographic study in 397 obstetric patients. Am J Roentgenol 157:545–548

    CrossRef  CAS  Google Scholar 

  • Conway JJ (1992) The “well tempered” diuretic renogram: a standard method to examine the asymptomatic neonate with hydronephrosis or hydroureteronephosis. J Nucl Med 33:2047–2051

    PubMed  CAS  Google Scholar 

  • El-Dahr SS, Chevalier RL (1990) Special needs of the newborn infant in fluid therapy. Pediatr Clin N Am 37:323–336

    CAS  Google Scholar 

  • Flynn JT (2000) Neonatal hypertension: diagnosis and management. Pediatr Nephrol 14:332–341

    PubMed  CrossRef  CAS  Google Scholar 

  • Hughson MD, Farris AB, Douglas-Denton R, Hoy WE, Bertram JF (2003) Glomerular number and size in autopsy kidneys: the relationship to birth weight. Kidney Int 63:2113–2122

    PubMed  CrossRef  Google Scholar 

  • Ismaili K, Avni FE, Wissing KM, Hall M (2004) Long-term clinical outcome of infants with mild and moderate fetal pyeloctasis: validation of neonatal ultrasound as a screening tool to detect significant nephrouropathies. J Pediatr 144:759–765

    PubMed  Google Scholar 

  • Kaplan BS, Restaino I, Raval DS, Gottlieb RP, Bernstein J (1994) Renal failure in the neonate associated with in utero exposure to non-steroidal anti-inflammatory agents. Pediatr Nephrol 8:700–704

    PubMed  CrossRef  CAS  Google Scholar 

  • Karlen J, Aperia A, Zetterstrom R (1985) Renal excretion of calcium and phosphate in preterm and term infants. J Pediatr 106:814–819

    PubMed  CrossRef  CAS  Google Scholar 

  • Oliveira EA, Diniz JSS, Cabral ACV, Leite HV, Colosimo EA, Oliveira RBB, Vilasboas AS (1999) Prognostic factors in fetal hydronephrosis: a multivariate analysis. Pediatr Nephrol 13:859–864

    PubMed  CrossRef  CAS  Google Scholar 

  • Rodriguez MM, Gomez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE (2004) Histomorphometric analysis of postnatal glomerulogenesis in extremely preterm infants. Pediatr Devel Pathol 7:17–25

    CrossRef  Google Scholar 

  • Rosenbaum DM, Korngold E, Teele RL (1984) Sonographic assessment of renal length in normal children. Am J Roentgenol 142:467–469

    CrossRef  CAS  Google Scholar 

  • Schwartz GJ, Haycock GB, Chir B, Edelmann CM, Spitzer A (1979) Late metabolic acidosis: a reassessment of the definition. J Pediatr 95:102–107

    PubMed  CrossRef  CAS  Google Scholar 

  • Schwartz GJ, Brion LP, Spitzer A (1987) The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin N Am 34:571–590

    CAS  Google Scholar 

  • Sedman AB, Kershaw DB, Bunchman TE (1995) Recognition and management of angiotensin converting enzyme inhibitor fetopathy. Pediatr Nephrol 9:382–385

    PubMed  CrossRef  CAS  Google Scholar 

  • Siegel SR, Oh W (1976) Renal function as a marker of human fetal maturation. Acta Paediatr Scand 65:481–485

    PubMed  CrossRef  CAS  Google Scholar 

  • Vanpee M, Blennow M, Linne T, Herin P, Aperia A (1992) Renal function in very low birth weight infants: normal maturity reached during early childhood. J Pediatr 121:784–788

    PubMed  CrossRef  CAS  Google Scholar 

  • White SL, Perkovic V, Cass A, Chang CL, Poulter NR, Spector T, Haysom L, Craig JC, Al Salmi I, Chadban SJ, Huxley RR (2009) Is low birth weight an antecedent of CKD in later life? A systematic review of observational studies. Am J Kid Dis 54:248–261

    PubMed  CrossRef  Google Scholar 

  • Woolf AS (2000) A molecular and genetic view of human renal and urinary tract malformations. Kidney Int 58:500–512

    PubMed  CrossRef  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert L. Chevalier M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Chevalier, R.L. (2012). Approach to Renal Disease in the Neonate. In: Elzouki, A.Y., Harfi, H.A., Nazer, H.M., Stapleton, F.B., Oh, W., Whitley, R.J. (eds) Textbook of Clinical Pediatrics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-02202-9_289

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-02202-9_289

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-02201-2

  • Online ISBN: 978-3-642-02202-9

  • eBook Packages: MedicineReference Module Medicine