Significance of fractional excretion of sodium and endothelin levels in the early diagnosis of renal failure in septic neonatal piglets.
OBJECTIVE
This experiment was designed to help understand the cascade of events that end in renal impairment in septic animals.


METHODS
Twenty 3- to 8-day-old piglets were anesthetized and the femoral artery, jugular and femoral veins, and bladder were catheterized. After stabilization under anesthesia with ventilatory support, they were divided into a control group and three groups that received endotoxin (ETX) in doses of 0.01 mg/kg, 0.025 mg/kg, and 0.05 mg/kg. Blood pressure and blood gases were monitored continuously. Blood and urine samples were obtained before (B), 1 hour (E1), and 3 hours (E3) after the bolus of ETX to determine glomerular filtration rate (GFR), fractional excretion of sodium (FENa), tumor necrosis factor (TNF), and endothelin-1 (ET-1) levels.


RESULTS
Incremental doses of ETX induce greater release of ET-1 with an early proportionate increase in FENa (P< .05) and late decrease in GFR (P< .05). TNF release is dose and time dependent after ETX injection (P < .05).


CONCLUSIONS
ET-1 and FENa are the best tests to evaluate renal failure during early sepsis in neonatal piglets.
Lievano
G
G
Division of Pediatric Surgery, University of Illinois College of Medicine at Chicago, USA.
Nguyen
L
L
Radhakrishnan
J
J
Fornell
L
L
Joshi
A
A
John
E G
EG
D058186:Acute Kidney Injury / Q000378:metabolism*; D000818:Animals; D000831:Animals, Newborn; D019332:Endothelin-1 / Q000378:metabolism*; D009102:Multiple Organ Failure / Q000378:metabolism; D018805:Sepsis / Q000378:metabolism*; D012964:Sodium / Q000378:metabolism*; D013552:Swine; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000378:metabolism
D019332:Endothelin-1; D014409:Tumor Necrosis Factor-alpha; D012964:Sodium