STUDY OF GLOMERULAR FUNCTIONS IN NEONATES

Glomerular function of neonates (25 full term and equal number of preterm neonates) at birth, on day seven and day fourteen were estimated by endogenous Creatinine clearance (CCr). The Preterm were divided into three groups viz. Group I (Gestation age (GA) 30-32 weeks), Group II (GA 33-34 weeks) and Group III (GA 35-36 weeks). Group IV consisted of 25 term neonates. Serum creatinine (in mg/dl) in all the groups of preterm ranged from 0.92 ± 0.153 to 1.204 ± 0.154 and in term neonate from 0.562 ± 0.175 to 1.148 ± 0.247 showing that the levels were inversely proportional to the period of gestation. Besides the Serum Creatinine levels in all groups of Preterm as well as term neonates were found to fall significantly (p < 0.001) during the first and second week. Glomerular filtration rate (GFR) in Group I were 16.603 ± 2.519, 19.786 ± 2.078 and 23.720 ± 2320 on day one, seven and fourteen respectively showing progressive improvement during the first two weeks. The GFRs were also found to be directly proportional to the GA. In addition the levels of GFR were found increasing significantly during the second week compared to that on day seven in all the groups of preterm neonates. GFR''s in Group I & II on all the three occasions were significantly lower (p < 0.001) than those of term counterparts, however the GFR on the first day in Group III neonates was lower than group IV, the difference was insignificant (p > 0.05). The increase in GFR in Group I on the three occasions was linear but insignificant (p > 0.05). The rise was more rapid & significant (p < 0.001) during the second week in Groups II & III. On the contrary the rate of improvement of GFR in full terms was quite rapid during the first week and gradual over the second week of life.KEY WORDS: GFR preterm & term neonates, Serum creatinine