SIGNIFICANCE OF FRACTIONAL EXCRETION OF SODIUM AND ENDOTHELIN LEVELS IN THE EARLY DIAGNOSIS OF RENAL-FAILURE IN SEPTIC NEONATAL PIGLETS

Purpose: This experiment was designed to help understand the cascade o f events that end in renal impairment in septic animals. Methods: Twen ty 3- to 8-day-old piglets were anesthetized and the femoral artery ju gular and femoral veins, and bladder were catheterized. After stabiliz ation under anesthesia with ventilatory support, they were divided int o a control group and three groups that received endotoxin (ETX) in do ses of 0.01 mg/kg, 0.025 mg/kg, and 0.05 mg/kg. Blood pressure and blo od gases were monitored continuously. Blood and urine samples were obt ained before (B), 1 hour (E1), and 3 hours (E3) after the bolus of ETX to determine glomerular filtration rate (GFR), fractional excretion o f sodium (FENa), tumor necrosis factor (TNF), and endothelin-l (ET-1) levels. Results: Incremental doses of ETX induce greater release of ET -I with an early proportionate increase in FENa (P < .05) and late dec rease in GFR (P < .05). TNF release is dose and time dependent after E TX injection (P < .05). Conclusion: ET-1 and FENa are the best tests t o evaluate renal failure during early sepsis in neonatal piglets. Copy right (C) 1998 by W.B. Saunders Company.