4.6 Article

Physiological Partial Aldosterone Resistance in Human Newborns

期刊

PEDIATRIC RESEARCH
卷 66, 期 3, 页码 323-328

出版社

SPRINGERNATURE
DOI: 10.1203/PDR.0b013e3181b1bbec

关键词

-

资金

  1. Inserm
  2. University Paris-Sud 11
  3. European Section of Aldosterone Council [ESAC]Centre Evian Pour l'Eau (Danone eaux France)
  4. Fonds d'Etudes pour la Recherche Medicale (Assistance Publique Hppitaux de Paris), France

向作者/读者索取更多资源

In the neonatal period, the human kidney is characterized by an impaired ability to regulate water and sodium homeostasis, resembling partial aldosterone resistance. The aim of our study was to assess this hormonal insensitivity in newborn infants and to determine its relationship with neonatal sodium handling. We conducted a prospective study in 48 healthy newborns and their mothers. Aldosterone, renin, and electrolyte concentrations were measured in umbilical cords and in maternal plasma. Urinary aldosterone concentrations and sodium excretion were determined at urination within 24 h after birth. A significant difference was observed between aldosterone and renin levels in newborn infants compared with their mothers (817 +/- 73 versus 575 +/- 55 pg/mL and 79 +/- 10 versus 15 +/- 2 pg/mL, respectively, p < 0.001). This hyperactivation of the renin-angiotensin-aldosterone system was associated with hyponatremia and hyperkalemia in the newborn infants, and high urinary sodium loss. consistent with a partial aldosterone resistance at birth. Unlike plasma aldosterone, urinary aldosterone concentration was found highly correlated with plasma potassium concentrations, thus representing the best index for accurate evaluation of mineralocorticoid sensitivity. Our study represents a comprehensive characterization of the renin-aldosterone axis in newborn infants and provides evidence for physiologic partial aldosterone resistance in the neonatal period. (Pediatr Res 66: 323-328, 2009)

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

Article Pediatrics

Mortality and significant neurosensory impairment in preterm infants: an international comparison

Marie Chevallier, Thierry Debillon, Brian A. Darlow, Anne R. Synnes, Veronique Pierrat, Elizabeth Hurrion, Junmin Yang, Anne Ego, Pierre Yves Ancel, Kei Lui, Prakeshkumar S. Shah, Thuy Mai Luu

Summary: The composite outcome of mortality and significant neurodisability in extremely preterm infants differed across high-income countries with similar baseline characteristics and access to healthcare. The French cohort (EPIPAGE-2) had higher rates of the composite outcome, primarily driven by increased mortality rates.

ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION (2022)

Article Pediatrics

Perinatal outcome and need of care for term asphyxiated newborns without moderate or severe hypoxic-ischemic encephalopathy

Alexandra Bower, Perrine Lorain, Gilles Kayem, Marc Dommergues, Laurence Foix-L'Helias, Isabelle Guellec

Summary: The study found that newborns with pathological foetal acidemia but without moderate or severe HIE may have metabolic disorders, require organ support, hospitalization, and blood sampling for detecting biological anomalies. Prospective studies are needed to establish consensus guidelines for managing this vulnerable population.

ACTA PAEDIATRICA (2022)

Article Obstetrics & Gynecology

The role of perinatal palliative care following prenatal diagnosis of major, incurable fetal anomalies: a multicentre prospective cohort study

C. de Barbeyrac, P. Roth, C. Noel, O. Anselem, A. Gaudin, C. Roumegoux, B. Azcona, C. Castel, M. Noret, E. Letamendia, J. Stirnemann, Y. Ville, A. Lapillonne, M-L Viallard, E. Kermorvant-Duchemin

Summary: This multicentre study investigated prenatal decision-making processes and birth plans in pregnancies amenable to perinatal palliative care. Only 10% of severe fetal anomalies eligible for termination of pregnancy involved perinatal palliative care plans. The study found that perinatal palliative care may not be a universal alternative to termination of pregnancy.

BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY (2022)

Article Obstetrics & Gynecology

Antibiotic prophylaxis in preterm premature rupture of membranes at 24-31 weeks' gestation: Perinatal and 2-year outcomes in the EPIPAGE-2 cohort

Elsa Lorthe, Mathilde Letouzey, Heloise Torchin, Laurence Foix L'Helias, Christele Gras-Le Guen, Valerie Benhammou, Pascal Boileau, Caroline Charlier, Gilles Kayem

Summary: This study compared different antibiotic prophylaxis after preterm premature rupture of membranes and found that prophylaxis based on third-generation cephalosporin may be associated with improved survival without severe neonatal morbidity compared to amoxicillin.

BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY (2022)

Article Pediatrics

Early Antibiotic Exposure and Adverse Outcomes in Very Preterm Infants at Low Risk of Early-Onset Sepsis: The EPIPAGE-2 Cohort Study

Mathilde Letouzey, Elsa Lorthe, Laetitia Marchand-Martin, Gilles Kayem, Caroline Charlier, Marine Butin, Ayoub Mitha, Monique Kaminski, Valerie Benhammou, Pierre-Yves Ancel, Pascal Boileau, Laurence Foix-L'Helias

Summary: This study aims to assess the association between early empirical antibiotic therapy and adverse outcomes in very preterm infants. The study found that early antibiotic exposure was associated with an increased risk of severe cerebral lesions and moderate-severe bronchopulmonary dysplasia in very preterm infants at low risk of early-onset sepsis.

JOURNAL OF PEDIATRICS (2022)

Article Pediatrics

Early-onset neonatal sepsis in the Paris area: a population-based surveillance study from 2019 to 2021

Paola Sikias, Valerie Biran, Laurence Foix-L'Helias, Celine Plainvert, Pascal Boileau, Stephane Bonacorsi

Summary: This population surveillance study provides data on the incidence, causative organisms, and antibiotic susceptibilities of early-onset sepsis in infants born at ≥34 weeks' gestation. The study highlights the higher frequency of group B Streptococcus (GBS) compared to Escherichia coli (E. coli) in term infants, and the significantly elevated risk of early-onset sepsis in late preterm infants due to E. coli. The findings suggest the need for improvement in the prevention of GBS early-onset sepsis and empiric antibiotic treatment of sepsis.

ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION (2023)

Article Genetics & Heredity

Management of copy number variants associated with incomplete penetrance and variable expressivity-Results of a French survey

Floriane Lejamtel, Cecile Oheix, Elisa Morales, Jelena Martinovic, Philippe Labrune, Francois Mickael Petit, Aline Receveur, Nelly Achour-Frydman, Alexandra Benachi, Chloe Puisney-Dakhli, Alexandre Joseph Vivanti

Summary: Increasing identification of neuro-susceptibility copy number variations (CNVs) has led to difficulties in predicting phenotypic features. The survey shows that multidisciplinary consultation is the key point in managing PIEV CNVs before conducting family surveys, which should be the basis for French recommendations.

CLINICAL GENETICS (2023)

Article Peripheral Vascular Disease

Mineralocorticoid Receptor Antagonism by Finerenone Attenuates Established Pulmonary Hypertension in Rats

Ly Tu, Raphael Thuillet, Julie Perrot, Mina Ottaviani, Emy Ponsardin, Peter Kolkhof, Marc Humbert, Say Viengchareun, Marc Lombes, Christophe Guignabert

Summary: Research showed that MR is overexpressed in preclinical models and human PAH, with inhibition by finerenone attenuating proliferation of pulmonary artery smooth muscle cells and partially reversing established pulmonary hypertension. The treatment also reduced total pulmonary vascular resistance and vascular remodeling, as well as decreasing inflammatory cell infiltration and vascular cell proliferation in rat lungs. This suggests that finerenone could be a potential therapy for PAH, warranting further investigation for clinical use alongside current treatments.

HYPERTENSION (2022)

Letter Pediatrics

Early Diagnosis of Ongoing Metabolic Bone Disease of Prematurity with Elevated Serum Alkaline Phosphatase

Maroua Jlassi, Ludivine Lecoq, Pierre-Yves Wachter, Amelie Durandy, Pascal Boileau, Emmanuelle Motte-Signoret

INDIAN JOURNAL OF PEDIATRICS (2023)

Article Pediatrics

Early skin-to-skin contact and risk of late-onset-sepsis in very and extremely preterm infants

Isabelle Le Ray, Pierre Kuhn, Mathilde Letouzey, Jean-Michel Roue, Ayoub Mitha, Isabelle Glorieux, Laurence Foix-L'Helias, Laetitia Marchand-Martin, Pierre-Yves Ancel, Monique Kaminski, Veronique Pierrat

Summary: This observational study evaluated the association between early skin-to-skin contact (SSC) and the incidence of late-onset sepsis (LOS) in extremely and very preterm infants. The results showed that early SSC exposure was not associated with the risk of LOS or LONI.

PEDIATRIC RESEARCH (2023)

Article Pediatrics

Circumstances, causes and timing of death in extremely preterm infants admitted to NICU: The EPIPAGE-2 study

Pascal Boileau, Mathilde Letouzey, Andrei S. Morgan, Elsa Lorthe, Monique Kaminski, Anaelle Coquelin, Elie Azria, Laurence Caeymaex, Florence Rouget, Caroline Diguisto, Olivier Claris, Barthelemy Tosello, Patrick Truffert, Pierre Betremieux, Valerie Benhammou, Laetitia Marchand-Martin, Francois Goffinet, Pierre-Yves Ancel, Laurence Foix-L'Helias

Summary: This study aims to describe the circumstances, causes, and timing of death in extremely preterm infants. The main causes of death were respiratory disease, CNS injury, and infection. Half of the deaths occurred within the first 7 days of life.

ACTA PAEDIATRICA (2023)

Article Pediatrics

Early elevated alkaline phosphatase as a surrogate biomarker of ongoing metabolic bone disease of prematurity

Emmanuelle Motte-Signoret, Marwa Jlassi, Ludivine Lecoq, Pierre-Yves Wachter, Amelie Durandy, Pascal Boileau

Summary: Very low birth weight (VLBW) neonates are at high risk of metabolic bone disease (MBD). This study aimed to find the easiest way to diagnose this disease early by identifying surrogate biomarkers before radiological signs appear. A 6-month observational study was conducted in a NICU, including all singleton VLBW neonates. Clinical and biological data, as well as nutritional intakes, were collected. Biological MBD (bMBD) was defined as alkaline phosphatase (ALP) levels above 600 IU/L at day of life 30 (DOL30), and a case-control analysis was performed. Out of 30 patients, 9 (30%) exhibited bMBD, all of whom had extremely low birth weight and were younger in gestational age and smaller in size at birth. There was no significant difference in nutritional intake between the bMBD and control groups. In the bMBD group, phosphatemia decreased since DOL3. ALP levels were already significantly elevated at DOL15, surpassing the normal range. Conclusions: Respectfully following nutritional guidelines does not completely prevent bMBD in high-risk patients. Early screening from DOL15, with ALP levels greater than 500 IU/L, could be sufficient for detecting upcoming MBD.

EUROPEAN JOURNAL OF PEDIATRICS (2023)

Article Medicine, General & Internal

Neonatal outcomes for women at risk of preterm delivery given half dose versus full dose of antenatal betamethasone: a randomised, multicentre, double-blind, placebocontrolled, non-inferiority trial

Thomas Schmitz, Muriel Doret-Dion, Loic Sentilhes, Olivier Parant, Olivier Claris, Laurent Renesme, Julie Abbal, Aude Girault, Heloise Torchin, Marie Houllier, Nolwenn Le Sache, Alexandre J. Vivanti, Daniele De Luca, Norbert Winer, Cyril Flamant, Claire Thuillier, Pascal Boileau, Julie Blanc, Veronique Brevaut, Pierre-Emmanuel Bouet, Geraldine Gascoin, Gael Beucher, Valerie Datin-Dorriere, Stephane Bounan, Pascal Bolot, Christophe Poncelet, Corinne Alberti, Moreno Ursino, Camille Aupiais, Olivier Baud

Summary: Comparison between a full dose and a half dose of antenatal betamethasone for preterm delivery showed that the half dose was not non-inferior to the full dose in terms of preventing respiratory distress syndrome. Therefore, reducing the dose of antenatal betamethasone is not recommended.

LANCET (2022)

暂无数据