Abstract
Late hyponatremia with negative sodium balance was previously seen in preterm infants in our hospital (Honour et al; 1979; Acta Paed Scand 63:813). Contributory factors were a low salt intake and renal insensitivity to the high aldosterone production (APR) which followed 2-3 weeks with low APR. By increasing sodium intakes we maintained sodium balance in 15 preterm infants. We found plasma renin activity 20920 ± 5650 ng/l/h around day 7 falling to 6472 ± 4500 ng/l/h around day 33. Corresponding plasma aldosterone concentrations were 4893 ± 2483 pmol/l and 3960 ± 3135 pmol/l. In 15 infants of 27 - 35, mean 31.3 weeks gestation tetrahydroaldosterone (THAldo) excretion rates were normal at 29.2 ± 24 μg/24h. The ratio of urinary 18-hydroxy-THA (principal metabolite of 18-hydroxycorticosterone ) to THAldo was 0.35 + 0.22. These data (1)exclude a defect in aldosterone biosynthesis (2) show PRA does not relate to sodium balance and (3) the adrenal zona glomerulosa response to angiotensin in the neonatal period may be inhibited by other factors such as atrial natriuretic peptide.
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Honour, J., Dillon, M., Cowen, J. et al. THE AETIOLOGY OF ALDOSTERONE SECRETION AND SODIUN HOMEOSTASIS IN PRETERM INFANTS. Pediatr Res 23, 111 (1988). https://doi.org/10.1203/00006450-198801000-00059
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DOI: https://doi.org/10.1203/00006450-198801000-00059