Renal processing of glucose in well and sick neonates.
OBJECTIVE
To determine the extent of renal processing of glucose in sick and well neonates.


METHODS
Glomerular filtration rate (GFR) and the renal processing of glucose, sodium, and water were measured using prolonged inulin infusion in 47 infants of 26-40 weeks of gestation, aged 1-13 days.


RESULTS
GFR rose by 15% after ventilatory support was withdrawn, and was unaffected by clinical instability. Fractional glucose excretion was low in the stable unventilated babies except at very high filtered loads, but rose in one unstable, unventilated baby. It was higher in ventilated babies, and remained high for at least six days after ventilation. For water and sodium, net differences between intake and urine excretion were not affected by ventilation, clinical stability, or glycosuria.


CONCLUSIONS
A combination of a low GFR and a high fluid intake, urine flow, and urine concentrating capacity, makes neonates very unlikely to develop an osmotic diuresis due to glycosuria while they have a blood glucose below 12 mmol/l, despite assertions to the contrary.
Coulthard
M G
MG
Department of Child Health Royal Victoria Infirmary Newcastle upon Tyne NE1 4LP.
Hey
E N
EN
D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D004231:Diuresis; D005919:Glomerular Filtration Rate; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D007328:Insulin; D007668:Kidney / Q000378:metabolism*; D009994:Osmolar Concentration; D012121:Respiration, Artificial; D012964:Sodium / Q000378:metabolism; D014882:Water-Electrolyte Balance
D001786:Blood Glucose; D007328:Insulin; D012964:Sodium; D005947:Glucose