12/13/2023 0 Comments Sodium normal range in infants![]() AVP secretion is increased in response to stress, such as birth, asphyxia, RDS, positive pressure ventilation, pneumothorax and intracranial hemorrhage. Arginine vasopressin (AVP, ADH) levels rise after birth.Increased aldosterone levels enhance distal tubular reabsorption of sodium resulting in an impaired ability to excrete a large, or acute, sodium load.The Renin-angiotensin system is very active in the first week of neonatal life resulting in increased vascular tone and elevated levels of aldosterone.Therefore, insensible water losses will be greatest with small size and decreased gestational age. The surface area of the newborn is relatively large and increases with decreasing size. A proportion of the diuresis observed in both term and preterm infants during the first days of life should be regarded as physiologic.After birth this excess water must be mobilized and excreted. The preterm fetus or neonate is in a state of relative total body water and extracellular fluid excess.The body composition of the fetus changes during gestation with a smaller proportion of body weight composed of water as gestation progresses.A rational approach to the management of fluid and electrolyte therapy in term and preterm neonates requires the understanding of several physiologic principles. Excess fluid administration in the very low birth weight infant is associated with patent ductus arteriosis and congestive heart failure, intraventricular hemorrhage, necrotizing enterocolitis and bronchopulmonary dysplasia. In the near term and term neonate excess fluid administration results in generalized edema and abnormalities of pulmonary function. Inadequate administration of fluids can result in hypovolemia, hypersomolarity, metabolic abnormalities and renal failure. Our study tries to show that urine spot sodium is not correlated with sodium intake, in fasting ill group it varied between 58 and 88 mEq/L, while in normal nonfasting children it was high between 142 and 168 mEq/L, while UNa/Cr in ill children is higher than control group with a wide range of changes and overlap with control grou P values compare to spot urine sodium.Fluid and electrolyte management in the newbornĬareful fluid and electrolyte management is essential for the well being of the sick neonate. Although in other studies the benefits of spot urine test has been investigated, spot UNa/Cr was attributed to hypertension, this ratio (UNa/Cr randomly) is also correlated to 24 h sodium excretion and can be correlated positively to gastric cancer risk stages. Sodium ion plays important role in blood pressure regulation, but sodium intake rarely used in clinical practice because of 24 h urine collection is cumbersome, while spot urine test can be desirable, although sodium excretion in random can be varied in different time of collection but in mid afternoon and early morning are more correlative with 24 h urine sodium excretion but in renal diseases estimation of 24 h sodium excretion by spot urine test cannot be reliable.Įighty-three percent of daily dietary intake can be excreted in urine, it was shown that 24 h sodium can be comparable with overnight collection, but not with spot urine test. Urine sodium is low (lower part), while UNa/Cr is high and overlapped with control group (upper part) There is not any correlation between urine sodium and received total sodium in grams per 24 h (r = −0.06, P = 0.7) or total sodium (mEq) per 24 h (r = −0.06, P = 0.7) there is not any correlation between urine sodium/creatinine (UNa/Cr) and total sodium intake in gram (r = −0.3, P = 0.1) and millie quivalent (r = −0.26, P = 0.1). Age of ill and starved children was between 24 and 156 months 66 ± 4 months, daily sodium intake was varied from 2.8 ± 0.7 g (minimum 2 g, maximum 4 g) or 48 ± 12 mEq. In this study, we try to find urine sodium changes in children who are receiving standard values of sodium (3 mEq/dL of maintenance fluid) as compared to healthy children who intake usual Iranian diet. Measurement of urine sodium is a vital matter which can show integrity of tubular function for reabsorption and low urine sodium indicate intact tubular function for sodium conservation, while high urine sodium may signify salt wasting causes and classification of hyponatremia, the reference range for urine sodium is 40–220 mEq/L/24 h.
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