Thursday, August 18, 2011

The Peculiarities of Kidney Function in Early Infancy

The peculiarities of renal function in early infancy are as follows
1. Glomerular filtration rate is low and does not reach adult values ​​until the child is between 1 and 2 years old.
2. There is great variation in the length of the tubular nephrons, although the size is less variable glomerular
3. The juxtaglomerular nephrons have a further development of cortical nephrons
4. The kidney's ability to concentrate child does not reach adult levelsuntil the third month of life.
5. The proper amount of antidiuretic hormone is secreted by the pituitary gland of the newborn, other factors seem to interfere with the reabsorption of water
6. The loop of Henle, which is essential for concentration, is not fully developed in the newborn.
7. The synthesis of excretory urea and the load is minimized.
8. The lowest concentration of urea, the end product of nitrogen metabolism, reduces your ability to concentrate, as evencontributes to the focusing mechanism
9. Newborns are able to excrete a water load at speeds of older people.
10. The excretion of hydrogen ions is reduced
11. Acid secretion is lower for the first year of life
12. Plasma bicarbonate level is low.
13. As a result of these weaknesses in the kidneys and blood less efficiently buffer, the baby is more likely to develop severe acidosis
14. Sodium excretion is reduced in the immediate neonatal, and kidneysare less able to adapt to scarcity and excess sodium
15. An infusion of saline may produce swelling due to the ability to remove excess sodium is compromised. In contrast, tubular sodium reabsorption inappropriate sodium loss can be done in disorders such as diarrhea or vmitting
16. Babies are less able to absorb glucose, and during the early days, for the production of ammonium ions.

Age quantitative, according to the characteristics of the kidneys andcollection system in children

1-3 days of life
• the volume of urine is 30-50 UV light for 24 hours (ml)
• The frequency of urination is 4-6 times / day
• The average volume of urine is 5-10 ml 1
• Urine specific gravity is 1006-1012
• glomerular filtration rate, according to creatinine clearance (endogenous) is 34-40 ml/min/1.73m2.

4-28 days of life
• urine volume is 200-300 UV for 24 hours (ml)
• Frequency of urination is20-25 times / day
• The average volume of 1 ml urine is 12-20
• Urine specific gravity is 1002-1006
• glomerular filtration rate, according to creatinine clearance (endogenous) is 40-50 ml/min/1.73m2

1-12 months of life
• The volume of urine is 600 UV for 24 hours (ml)
• Frequency of urination is 10-25 times / day
• The average volume of urine is 50-60 ml 1
• Urine specific gravity is 1004-1008
• glomerularfiltration rate, according to creatinine clearance (endogenous) is 60-70 ml/min/1.73m2

1-3 years of life
• The volume of urine is 700 UV for 24 hours (ml)
• Frequency of urination is 8-10 times / day
• The average volume of urine is 80-90 ml 1
• Urine specific gravity is 1009-1012
• glomerular filtration rate, according to creatinine clearance (endogenous) is 70-100 ml/min/1.73m2

3-6 years of life
• the volume of urine is800-1000 UV for 24 hours (ml)
• The frequency of urination is 6-8 times / day
• The average volume of 1 ml urine was 90-100
• Urine specific gravity is 1010-1016
• glomerular filtration rate, according to creatinine clearance (endogenous) is 100-120 ml/min/1.73m2

60-10 years old
• 1100-1500 the volume of urine is the UV radiation for 24 hours (ml)
• The frequency of urination is 5-6 times / day
• The average volume of urine is a 100-150ml
• Urine specific gravity is 1012-1020
• glomerular filtration rate, according to creatinine clearance (endogenous) is 120-140 ml/min/1.73m2

Locating the kidneys on the base of the spine

Baby
• The left side of the summit is higher at the bottom of the eleventh thoracic vertebra
• The narrowest part of the summit on the top floor of the twelfth thoracic vertebra
• The bottom left of the point below the iliaccrest.

3-5 months
• The left side of the summit on the top floor of the twelfth thoracic vertebra
• The top right of the summit at the bottom of the twelfth thoracic vertebra

1 year
• The left apex is at the bottom of the twelfth thoracic vertebra
• The right side of the apex is at the bottom of the twelfth thoracic vertebra

2 years
• The left side ofthe upper apex is located like in Adult
• The right side of the upper apex is located like in Adult
• The left side of the lower apex is located above the iliac crest.

Any conspicuous deviation form any of these normal indexes indicate one thing- an abnormality!

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