BOOK
Nephrology and Fluid/Electrolyte Physiology: Neonatology Questions and Controversies E-Book
William Oh | Jean-Pierre Guignard | Stephen Baumgart
(2012)
Additional Information
Book Details
Abstract
Nephrology and Fluid/Electrolyte Physiology, a volume in Dr. Polin’s Neonatology: Questions and Controversies Series, offers expert authority on the toughest neonatal nephrology and fluid/electrolyte challenges you face in your practice. This medical reference book will help you provide better evidence-based care and improve patient outcomes with research on the latest advances.
- Reconsider how you handle difficult practice issues with coverage that addresses these topics head on and offers opinions from the leading experts in the field, supported by evidence whenever possible.
- Find information quickly and easily with a consistent chapter organization.
- Get the most authoritative advice available from world-class neonatologists who have the inside track on new trends and developments in neonatal care.
- Stay current in practice with coverage on lung fluid balance in developing lungs and its role in neonatal transition; acute problems of prematurity: balancing fluid volume and electrolyte replacement in very-low-birth-weight and extremely-low-birth-weight neonates; and much more.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Pin page | fm2 | ||
| Half-title page | i | ||
| Series page | ii | ||
| Nephrology and Fluid/Electrolyte Physiology: Neonatology Questions and Controversies | iii | ||
| Copyright Page | iv | ||
| Contributors | v | ||
| Series Foreword | ix | ||
| Foreword | x | ||
| Preface | xi | ||
| Table Of Contents | xiii | ||
| Front Matter | xv | ||
| A Placenta and Fetal Water Flux | 1 | ||
| 1 Water Flux and Amniotic Fluid Volume: | 3 | ||
| Clinical Scenarios | 3 | ||
| Maternal Dehydration | 3 | ||
| Reduced Maternal Plasma Oncotic Pressure | 3 | ||
| Fetal Water | 4 | ||
| Placental Water Flux | 4 | ||
| Fetal Water Compartments | 4 | ||
| Amniotic Fluid Volume and Composition | 5 | ||
| Fetal Water Circulation | 5 | ||
| Urine Production | 5 | ||
| Lung Fluid Production | 6 | ||
| Fetal Swallowing | 6 | ||
| Intramembranous Flow | 7 | ||
| Mechanisms of Water Flow | 7 | ||
| Mechanism of Placental Water Flow | 8 | ||
| Placental Anatomy | 8 | ||
| Controversies in Placental Flow | 9 | ||
| Mechanism of Intramembranous Flow | 11 | ||
| Membrane Anatomy | 11 | ||
| Controversies Regarding Intramembranous Flow | 11 | ||
| Aquaporins | 12 | ||
| Aquaporins in Placentas and Membranes | 13 | ||
| Aquaporin and Intramembranous Water Flow | 13 | ||
| Conclusion | 14 | ||
| References | 15 | ||
| 2 Body Water Changes in the Fetus and Newborn: | 19 | ||
| Body Fluid Compartments | 19 | ||
| Body Water in Fetal Growth Aberration | 20 | ||
| Large for Gestational Age | 20 | ||
| Intrauterine Growth Restriction or Small for Gestational Age | 21 | ||
| Body Water and Solids in Intrauterine Growth Restriction or Small for Gestational Age Infants | 21 | ||
| Transitional Changes of Body Water after Birth | 23 | ||
| Clinical implications of Transitional Body Water Changes in Preterm Very Low Birth Weight Infants | 24 | ||
| References | 26 | ||
| B Electrolyte Balance during Normal Fetal and Neonatal Development | 29 | ||
| 3 Renal Aspects of Sodium Metabolism in the Fetus and Neonate | 31 | ||
| Body Water Compartments | 31 | ||
| Cell Volume Regulation | 32 | ||
| Fetal Sodium Metabolism | 33 | ||
| Amniotic Fluid Dynamics | 33 | ||
| Mechanisms of Placental Sodium Transfer | 34 | ||
| Fetal Homeostatic Reactions | 35 | ||
| Body Water Compartments and Initial Weight Loss | 36 | ||
| Physical Water Compartments | 37 | ||
| The Principle of Physical Water Compartments | 38 | ||
| Determination of Motionally Distinct Water Fractions | 38 | ||
| Physical Water Compartments during the Early Postnatal Period | 38 | ||
| Role of Hyaluronan in the Perinatal Lung and Brain Water Metabolism | 39 | ||
| Role of Hyaluronan in Neonatal Renal Concentration | 39 | ||
| Sodium Homeostasis | 39 | ||
| Renal Sodium Excretion under Basal Conditions | 39 | ||
| Molecular Basis of Proximal Tubular Sodium Reabsorption | 42 | ||
| Molecular Basis of Distal Tubular Sodium Reabsorption | 43 | ||
| Other Factors Influencing Renal Sodium Handling | 44 | ||
| Renal Sodium Excretion in Response to Salt Loading | 45 | ||
| Intestinal Sodium Transport | 47 | ||
| Disturbances in Plasma Sodium Concentrations | 48 | ||
| Early-Onset Hyponatremia | 48 | ||
| Late-Onset Hyponatremia | 48 | ||
| Early Hypernatremia | 51 | ||
| Clinical Consequences of Inadequate Sodium Intake | 51 | ||
| Clinical Consequences of Excessive Sodium Intake | 52 | ||
| Sodium Homeostasis and Acid–Base Balance | 53 | ||
| References | 53 | ||
| 4 Potassium Metabolism | 61 | ||
| Normal Metabolism | 61 | ||
| Regulation of Internal K Balance | 61 | ||
| Regulation of External K Balance | 63 | ||
| Renal Potassium Excretion | 63 | ||
| Intestinal Potassium Excretion | 66 | ||
| Sweat Gland Potassium Excretion | 67 | ||
| Plasma [K+] | 67 | ||
| Feedback and Feedforward Control of Plasma [K+] | 67 | ||
| Developmental Physiology | 68 | ||
| Fetus | 68 | ||
| Neonate | 69 | ||
| Internal Potassium Metabolism | 69 | ||
| Renal Potassium Metabolism | 69 | ||
| Intestinal K Metabolism | 70 | ||
| Feedback and Feedforward Control of Plasma [K+] | 70 | ||
| Clinical Relevance | 70 | ||
| Hyperkalemia | 70 | ||
| Spurious Hyperkalemia | 70 | ||
| Nonoliguric Hyperkalemia | 70 | ||
| Renal Failure | 71 | ||
| Hypokalemia | 71 | ||
| Loop and Thiazide Diuretics | 71 | ||
| Alkalosis | 72 | ||
| References | 72 | ||
| 5 Renal Urate Metabolism in the Fetus and Newborn | 75 | ||
| Uric Acid in Human Disease | 75 | ||
| Uric Acid in Diseases of Fetuses and Newborns | 77 | ||
| Generation of Uric Acid | 77 | ||
| Glomerular Filtration Rate | 78 | ||
| Proximal Tubular Urate Transport | 79 | ||
| Developmental Implications and Conclusions | 80 | ||
| References | 81 | ||
| 6 Perinatal Calcium and Phosphorus Metabolism | 85 | ||
| Body Distribution | 85 | ||
| Calcium | 85 | ||
| Phosphorus | 86 | ||
| Regulation of Serum Calcium and Phosphorous Concentrations | 87 | ||
| Calcium | 87 | ||
| Parathyroid Hormone | 87 | ||
| Placental Transport | 88 | ||
| Serum Calcium and Calcium Homeostasis after Birth | 88 | ||
| Vitamin D | 88 | ||
| Calcitonin | 89 | ||
| Phosphorus | 89 | ||
| Placental Transport | 89 | ||
| Fibroblast Growth Factor 23 | 90 | ||
| Renal Excretion | 91 | ||
| Parathyroid Hormone | 91 | ||
| Serum Phosphorous and Phosphorous Homeostasis after Birth | 91 | ||
| Clinical Disorders Associated with Abnormal Calcium and Phosphorus Homeostasis | 92 | ||
| Neonatal Hypocalcemia | 92 | ||
| Definition | 92 | ||
| Etiology and Pathophysiology | 92 | ||
| Clinical Presentation | 93 | ||
| Diagnosis | 93 | ||
| Therapeutic Approaches | 93 | ||
| Neonatal Hypercalcemia | 94 | ||
| Definition | 94 | ||
| Etiology and Pathophysiology | 94 | ||
| Clinical Presentation | 95 | ||
| Diagnosis | 96 | ||
| Therapeutic Approaches | 96 | ||
| Neonatal Hypophosphatemia | 97 | ||
| Definition | 97 | ||
| Etiology and Pathophysiology | 97 | ||
| Clinical Presentation | 98 | ||
| Therapeutic Approaches | 99 | ||
| Neonatal Hyperphosphatemia | 99 | ||
| Definition | 99 | ||
| Etiology and Pathophysiology | 99 | ||
| Clinical Presentation | 100 | ||
| Therapeutic Approaches | 100 | ||
| References | 100 | ||
| 7 Acid–Base Homeostasis in the Fetus and Newborn | 105 | ||
| Regulation of Acid–Base Homeostasis | 105 | ||
| Respiratory Acidosis | 105 | ||
| Correction of Fetal Respiratory Acidosis | 105 | ||
| Correction of Postnatal Respiratory Acidosis | 106 | ||
| Metabolic Acidosis | 106 | ||
| Fetoplacental Elimination of Metabolic Acid Load | 106 | ||
| Postnatal Elimination of Metabolic Acid Load | 107 | ||
| Respiratory Alkalosis | 109 | ||
| Correction of Fetal Respiratory Alkalosis | 109 | ||
| Correction of Postnatal Respiratory Alkalosis | 109 | ||
| Metabolic Alkalosis | 109 | ||
| Correction of Fetal Metabolic Alkalosis | 109 | ||
| Correction of Postnatal Metabolic Alkalosis | 109 | ||
| Normal Acid–Base Balance and Growth | 110 | ||
| Obstetric Management and Fetal and Neonatal Acid–Base Balance | 111 | ||
| Summary | 112 | ||
| References | 112 | ||
| C The Kidney: Normal Development and Hormonal Control | 115 | ||
| 8 Glomerular Filtration Rate in Neonates | 117 | ||
| Development of Glomerular Filtration | 117 | ||
| Vasoactive Factors | 118 | ||
| Angiotensin II | 118 | ||
| Prostaglandins | 119 | ||
| Maturational Aspects of the Renin–Angiotensin and Prostaglandins Systems | 119 | ||
| The Renin–Angiotensin System | 119 | ||
| The Prostaglandins | 120 | ||
| Assessment of Glomerular Filtration Rate | 120 | ||
| Glomerular Markers | 120 | ||
| Inulin | 121 | ||
| Inulin as a Marker of Glomerular Filtration Rate in Neonates | 121 | ||
| Creatinine | 121 | ||
| Creatinine as a Marker of GFR in the Neonate | 122 | ||
| Iohexol | 122 | ||
| Iothalamate Sodium | 122 | ||
| 99mTc-DTPA and 51Cr-EDTA | 123 | ||
| Techniques Used to Assess Glomerular Filtration Rate in Neonates | 123 | ||
| The Plasma Concentration | 123 | ||
| Urinary Clearance | 124 | ||
| Inulin | 124 | ||
| Creatinine | 124 | ||
| The Constant Infusion Technique without Urine Collection | 125 | ||
| The Single-Injection (Plasma Disappearance Curve) Technique | 126 | ||
| Estimation of Creatinine Clearance from Its Plasma Concentration without Urine Collection | 126 | ||
| The Special Case of Cystatin C: A Nonclassical Glomerular Marker! | 127 | ||
| Cystatin C as a Marker of Glomerular Filtration Rate in Neonates | 127 | ||
| Assessment of Renal Function in Neonates: Which Method for Which Purpose? | 128 | ||
| Developmental Investigative Studies | 128 | ||
| Clinical Purposes | 129 | ||
| Conditions and Factors That Impair Glomerular Filtration Rate | 129 | ||
| Perinatal Asphyxia | 129 | ||
| Nonsteroidal Antiinflammatory Agents | 129 | ||
| Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Antagonists | 130 | ||
| Prevention of Oliguric States Caused by Low Glomerular Filtration Rate | 131 | ||
| Furosemide in Oliguric Neonates | 131 | ||
| Dopaminergic Agents (Dopamine, Dopexamine) in Oliguric Neonates | 131 | ||
| Theophylline | 131 | ||
| References | 132 | ||
| D Special Problems | 137 | ||
| 9 The Developing Kidney and the Fetal Origins of Adult Cardiovascular Disease | 139 | ||
| Developmental Origins of Health and Disease | 139 | ||
| Birth Weight and Developmental Origins of Adult Cardiovascular and Renal Diseases | 140 | ||
| Postnatal Growth and Developmental Origins of Adult Cardiovascular and Renal Diseases | 141 | ||
| Biologic Mechanism of Developmental Programming of Adult Disease | 143 | ||
| Developing Kidney and Long-Term Consequences | 143 | ||
| Nephrogenesis and Environment | 144 | ||
| Long-Term Vascular and Renal Disease: Role of Nephron Number | 145 | ||
| Developing Kidney, Postnatal Factors, and Long-Term Vascular and Renal Diseases | 146 | ||
| Molecular Mechanisms Involved in the Developmental Origins of Cardiovascular Disease | 147 | ||
| Fetal Environment and Altered Kidney Gene Expression | 147 | ||
| Imprinted Genes and Programming | 148 | ||
| Genomic Imprinting and Nutrient Supply to the Fetus | 148 | ||
| Conclusion | 149 | ||
| References | 150 | ||
| 10 Renal Modulation: | 155 | ||
| Components of the Renin–Angiotensin– Aldosterone System | 155 | ||
| Angiotensin Generation | 155 | ||
| Renin–Angiotensin System Outside Juxtaglomerular Cells | 155 | ||
| Effects of Angiotensin-Converting Enzyme and Non–Angiotensin-Converting Enzyme Other Than the Production of Angiotensin II | 157 | ||
| Cardiovascular System | 157 | ||
| Adipocytes | 157 | ||
| Renal | 157 | ||
| Mesenteric Bed | 157 | ||
| Angiotensin II and Its Metabolites | 158 | ||
| Aldosterone | 158 | ||
| Gene Targeting of Angiotensin Synthesis: Lessons from Genetically Manipulated Rodents | 158 | ||
| Angiotensin Receptors | 159 | ||
| Gene Targeting of Angiotensin Receptors | 160 | ||
| Other Angiotensin II Receptors | 160 | ||
| Renin Receptors | 160 | ||
| Physiologic Effects of Angiotensin II | 161 | ||
| Via the Angiotensin1 Receptor | 161 | ||
| Via the Angiotensin2 Receptor | 161 | ||
| Concepts and Controversies in Our Current Understanding of the Renal Effects of the Renin–Angiotensin–Aldosterone System in Maintaining Fluid and Electrolyte Homeostasis and Blood Pressure | 162 | ||
| Ontogeny | 162 | ||
| Development of the Renin–Angiotensin–Aldosterone System: Structure of the Kidney and Urinary Tract | 162 | ||
| Studies in Humans | 162 | ||
| Postnatal Changes in Renin–Angiotensin–Aldosterone System Structure and Function in Humans | 163 | ||
| Sodium Homeostasis in the Neonatal Period | 163 | ||
| Development of Tubuloglomerular Feedback | 164 | ||
| Development of Glomerulotubular Balance | 164 | ||
| Current Concepts and Controversies | 165 | ||
| What is the Physiologic Basis and Purpose, If Any, of the “Third Mechanism?” | 166 | ||
| Mediators and Modulators of Tubuloglomerular Feedback | 166 | ||
| Adenosine | 167 | ||
| Adenosine Triphosphate | 167 | ||
| Nitric Oxide | 167 | ||
| Reactive Oxygen Species | 168 | ||
| Sodium Transporters | 168 | ||
| Sodium Potassium 2 Chloride Co-transporters | 168 | ||
| Na+, K+-ATPase | 168 | ||
| Calcium Wave | 169 | ||
| New Directions | 169 | ||
| Unconventional Behavior of Renin–Angiotensin System Components | 169 | ||
| Molecular Mechanisms Underlying Salt Sensing by the Macula Densa | 169 | ||
| Fetal Programming for Hypertension: Failure of Renoprotection? | 169 | ||
| Clinical Aspects | 170 | ||
| References | 170 | ||
| 11 Renal Modulation: | 179 | ||
| Arginine Vasopressin | 180 | ||
| Normal Arginine Vasopressin Physiology | 180 | ||
| Arginine Vasopressin Synthesis | 180 | ||
| Sensor Mechanisms for Arginine Vasopressin Secretion | 180 | ||
| Arginine Vasopressin Receptors and Signal Transduction | 181 | ||
| Renal Arginine Vasopressin Action and Aquaporin 2 Water Channels | 182 | ||
| Modulation of Arginine Vasopressin Action | 182 | ||
| Developmental Differences Between Fetuses and Newborn Infants | 182 | ||
| Role of Arginine Vasopressin in the Placenta | 182 | ||
| Arginine Vasopressin in Fetal Life | 183 | ||
| Arginine Vasopressin in Newborns | 184 | ||
| Role of Arginine Vasopressin in Pathologic Conditions of Neonates | 185 | ||
| Diabetes Insipidus | 185 | ||
| Syndrome of Inappropriate Secretion of Antidiuretic Hormone | 185 | ||
| Arginine Vasopressin Secretion in Neonatal Pathologic Conditions | 185 | ||
| Atrial Natriuretic Peptide | 186 | ||
| Normal Physiology of Atrial Natriuretic Peptide and Related Natriuretic Peptides | 186 | ||
| Introduction to Natriuretic Peptides | 186 | ||
| Synthesis of Natriuretic Peptides | 186 | ||
| Sensor Mechanisms for Atrial Natriuretic Peptide Secretion | 186 | ||
| Natriuretic Peptide Receptors and Signal Transduction | 186 | ||
| Biologic Action of Natriuretic Peptides | 187 | ||
| Modulation of Atrial Natriuretic Peptide Action | 188 | ||
| Developmental Differences Between Fetuses and Newborn Infants | 188 | ||
| Role of Atrial Natriuretic Peptide in the Placenta | 188 | ||
| Atrial Natriuretic Peptide in Fetal Life | 189 | ||
| Atrial Natriuretic Peptide in Newborns | 190 | ||
| Role of Atrial Natriuretic Peptide in Pathologic Conditions of Newborns | 190 | ||
| Fetal Distress | 190 | ||
| Postnatal Diseases | 191 | ||
| Congestive Heart Failure and Congenital Heart Diseases | 191 | ||
| References | 192 | ||
| 12 Acute Problems of Prematurity: | 199 | ||
| Immature Epidermal Barrier Function and the Extremely Low Birth Weight Habitus | 200 | ||
| Transcutaneous (Insensible) Water Loss | 201 | ||
| Water Loss and Pathogenesis of Transcutaneous Dehydration | 202 | ||
| Salt Restriction Prophylaxis | 203 | ||
| Nonoliguric Hyperkalemia in Extremely Low Birth Weight Babies | 205 | ||
| The Epidermal Barrier: Reducing Transcutaneous Evaporation | 208 | ||
| Environmental Humidification | 208 | ||
| Skin Emollients | 209 | ||
| Plastic Shields, Bags, and Blankets | 210 | ||
| Pulmonary Edema Formation | 210 | ||
| Prevention of Iatrogenic Fluid Overload | 211 | ||
| Diuretic Therapy | 213 | ||
| Corticosteroid Therapy | 213 | ||
| Electrolyte Imbalances and Neurodevelopment | 214 | ||
| Hyponatremia | 214 | ||
| Hypernatremia | 215 | ||
| Areas for Further Investigation | 215 | ||
| Between a Rock and a Hard Place: Suggestions for Vigilant Fluid Balance Therapy in Extremely Low Birth Weight Babies | 216 | ||
| A Parting Shot at Aggressive Patent Ductus Arteriosus Management | 217 | ||
| Conclusion | 218 | ||
| References | 218 | ||
| 13 Lung Fluid Balance in Developing Lungs and Its Role in Neonatal Transition | 221 | ||
| Fetal Lung Liquid and Its Physiologic Significance | 221 | ||
| How Is the Fetal Lung Fluid Cleared? | 224 | ||
| Sodium Channel Pathology in the Lung | 225 | ||
| What Causes the Neonatal Lung Epithelium to Switch to an Absorptive Mode? | 227 | ||
| Summary | 229 | ||
| References | 229 | ||
| 14 Use of Diuretics in the Newborn | 233 | ||
| Body Fluid Homeostasis | 233 | ||
| Extracellular Fluid Volume | 233 | ||
| Plasma Osmolality | 233 | ||
| Clinical Use of Diuretics | 234 | ||
| Sodium-Retaining States | 234 | ||
| Oliguric States | 234 | ||
| Respiratory Disorders | 234 | ||
| Central Nervous System Disorders | 234 | ||
| Electrolyte Disorders | 234 | ||
| Nephrogenic Diabetes Insipidus | 234 | ||
| Arterial Hypertension | 235 | ||
| Differential Diagnosis of Congenital Tubulopathies | 235 | ||
| Classification of Diuretics According to the Site of Action | 235 | ||
| Filtration Diuretics | 236 | ||
| Osmotic Diuretics | 239 | ||
| Index | 361 | ||
| A | 361 | ||
| B | 362 | ||
| C | 363 | ||
| D | 364 | ||
| E | 365 | ||
| F | 366 | ||
| G | 366 | ||
| H | 367 | ||
| I | 369 | ||
| J | 369 | ||
| K | 369 | ||
| L | 369 | ||
| M | 370 | ||
| N | 370 | ||
| O | 371 | ||
| P | 371 | ||
| R | 373 | ||
| S | 373 | ||
| T | 375 | ||
| U | 376 | ||
| V | 376 | ||
| W | 376 | ||
| X | 377 |