Body electrolytes in bronchopulmonary dysplasia and the effects of diuretic therapy |
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Authors: | Rita Prasad Verma Eunice John Linda Fornell Dharmpuri Vidyasagar |
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Institution: | (1) Department of Pediatrics, Hahnemann University Hospital, Broad and Vine Streets, MS # 402, 191 02 Philadelphia, PA, U.S.A.;(2) Department of Pediatrics, University of Illinois Hospital, Chicago, Illinois, U.S.A. |
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Abstract: | Body electrolytes and their regulatory hormones were studied in preterm infants who suffered from bronchopulmonary dysplasia
under two groups: those who were not treated with diuretics (Group II), and those who were treated with diuretics (Group III).
The values were compared with a group of matched healthy controls (Group I). Lower serum Na levels, a need of higher Na intake,
and higher urinary Na concentrations and urinary specific gravity were found in Group II infants. FeNa was normal and the
urinary flow rate was lower than the controls. These data suggest an inability of these infants to dilute urine. Group III
infants who were treated with diuretics showed higher serum Na levels and lower urinary specific gravity than Group II infants.
These values, as well as water and Na intake/output ratios, were all similar to the control values. Serum aldosterone level
was highest in Group II but did not reach significance. Intracellular K concentration was not different between the groups
indicating an optimum total body K balance. A significant negative correlation between serum Na and aldosterone levels was
found in Group II infants, which was not noted in the controls. Significant correlations were also found between FeNa and
plasma aldosterone level in the BPD groups, unlike the controls. The control group of infants showed significant positive
correlation between Na balance and serum Na levels. Our results suggest that inability to dilute urine appropriately might
be the reason for the BPD patients to retain body water. Water restriction and diuretic therapy therefore are reasonable therapeutic
approaches in such cases. |
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Keywords: | Potassium (K) Sodium (Na) Respiratory distress syndrome (RDS) Plasma aldosterone level (ALD) Plasma renin activity (PRA) Creatinine clearance (Ccr) Plasma arginine vasopressin level (PAVP) Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) |
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