RENAL-FUNCTION IN SICK, VERY-LOW-BIRTH-WEIGHT INFANTS

Renal immaturity is pronounced in very low-birth-weight infants with a gestational age less-than-or-equal-to 30 weeks. We attempted to eluci date if conditions requiring mechanical ventilation, including patent ductus arteriosus, might further compromise renal function due to decr eased renal perfusion. Forty infants studied between 4 and 28 days of age were divided into four groups: Control with no patent ductus or me chanical ventilation (n = 8); PDA + MV, with both patent ductus and me chanical ventilation (n = 17); PDA, with patent ductus (n = 6); MV, wi th mechanical ventilation (n = 9). The groups PDA + MV and MV had sign ificantly lower creatinine clearances and significantly higher fractio nal sodium excretions than controls. Mean arterial pressure was signif icantly lower in all groups compared to controls and correlated signif icantly with creatinine clearance (r = 0.47, p < 0.02). In conclusion, low renal function in these infants is further compromised by a paten t ductus arteriosus and/or the use of mechanical ventilation.