Free water deficit
Replace 4 ml/kg for every 1 over 145NA
If over 170, replace 3ml/kg
Reasons for reduced concentrating capability in premies
Insensitivity to vasopressin
Short loop of henle
Low osmolarity of medullary interstitium
Low serum urea
Urine starts at
10-12 weeks
Nephrons are starting to form
8 wks
FENa%
Urine Na x plasma cr/ urine cr x plasma Na x100
FeNa interpretation
<1
1-2.5
>3
Normal
Pre-renal
Intrinsic renal failure
Renin made by —- due to ——
Juxtaglomerular cells due to decreased perfusion and increased sympathetic activity
Angiotensinogen gets converted to
Angiotensin 1 by renin
Angiotensin 1 gets converted
To angiotensin 2 by ACE
Angiotensin 2 stimulates
The release of aldosterone
Angiotensin 2 causes
Vasoconstriction
Release of ADH
Release of aldosterone
Activates vit D by PTH
Activates EPO
Increases sodium and water reabsoption
Aldosterone
Acts on kidney to increase sodium and chloride , get rid of K and H+
Hyponatremia and bio loss during the first few days of life in premature infants is due to
Lack of response to aldosterone in the kidney
Why do RTAS have pork growth?
Decreased growth, hormone, and bone resorption due to the persistent acidosis
Renin is secreted from where
Juxtaglomerular cells in the kidney
Angiotensin is located where
Liver
Angiotensin 1 gets converted to 2 where
Lung
Effects of angiotensin 2
Increased sodium in water absorption
Arterial vasoconstriction
Increase ADH
Increase aldosterone
Increase vitamin vitamin D
Increased EPO
Angiotensin2 leads to
Aldosterone release from adrenal gland and works on the kidney to retain sodium and chloride
Giving bicarb can cause
Increase in your CO2
Increased sodium, decreased potassium, and decrease calcium
Increase your IVH risk
Most common causes Renal failure
Hie
Most common cause of hydronephrosis
- High fetal urine output.
- Most common structural abnormality would be UPJ obstruction.
Pre- renal fena
Less than 2.5
Intrinsic renal fena
More than 3
