Article |

Renal Adaptation to Extrauterine Life in Patients With Respiratory Distress Syndrome

Andrew T. Costarino, MD; Stephen Baumgart, MD; Michael E. Norman, MD; Richard A. Polin, MD
Am J Dis Child. 1985;139(10):1060-1063. doi:10.1001/archpedi.1985.02140120106039.
Text Size: A A A
Published online

• A spontaneous diuresis that precedes the improvement of pulmonary function has been described in patients with respiratory distress syndrome (RDS). The developmental changes in renal physiology responsible for this spontaneous diuresis are not completely understood. To describe the mechanisms responsible for the spontaneous diuresis, serial renal function studies were performed during the first five days of life in nine premature neonates with RDS. Diuresis was defined as a urine output that was at least 80% of fluid intake; prediuretic, diuretic, and postdiuretic periods were observed in all study infants. Oxygenation did not improve until the postdiuretic period. Renal function studies disclosed a significant increase in free water clearance during the diuresis with the production of dilute urine and a reciprocal rise in serum sodium concentration and plasma osmolality. The glomerular filtration rate increased at the onset of diuresis and remained elevated after the diuresis ended; however, the proportion of filtrate excreted was significantly elevated during the diuresis compared with prediuretic and postdiuretic values. These data suggest that the diuresis in patients with RDS is a water diuresis secondary to an endogenous water load.

(AJDC 1985;139:1060-1063)


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.