Renal aspects of metabolic acid-base disorders in neonates.

Détails

ID Serval
serval:BIB_0CFF0E3F5B81
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Renal aspects of metabolic acid-base disorders in neonates.
Périodique
Pediatric nephrology
Auteur(s)
Iacobelli S., Guignard J.P.
ISSN
1432-198X (Electronic)
ISSN-L
0931-041X
Statut éditorial
Publié
Date de publication
02/2020
Peer-reviewed
Oui
Volume
35
Numéro
2
Pages
221-228
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Acid-base homeostasis is one of the most tightly regulated systems in the body. Maintaining the acid-base balance is particularly challenging for preterm infants and growing neonates. The kidney, which represents the crucial ultimate line of defense against disturbances of acid-base balance, undergoes a complex maturation process during the transition from a fetal to an extra-uterine environment. This review article summarizes the physiology of acid-base regulation by the immature human kidney and discusses disorders of acid-base balance, such as metabolic acidosis, respiratory acidosis, metabolic alkalosis, and respiratory alkalosis. In conditions of metabolic acidosis, the serum anion gap and the urinary anion gap can be useful tools to define the nature of the acidosis. Metabolic acidosis can reflect a decrease in glomerular filtration rate, or be the consequence of selective disorders of proximal or distal tubular function. Most tubulopathies associated with metabolic acidosis observed in neonates are primary, hereditary, isolated tubulopathies. Proximal renal tubular acidosis is characterized by bicarbonate wasting, while the distal types of renal tubular acidosis are secondary to distal acidification defects. All tubulopathies are associated with hypokalemia, with the exception of type 4 hyperkalemic distal renal tubular acidosis. The transporter defects in the various acid-base tubulopathies are now well defined. Treatment of the acidosis varies according to the site and mechanism of the defect. Chronic renal tubular acidosis or alkalosis severely impair growth and calcium metabolism. Early rational therapeutic intervention can prevent some of the consequences of the disorders and improves the prognosis.
Mots-clé
Acidemia, Alkalemia, Anion gap, Bicarbonate, Growth failure, Immaturity, Physiological approach, Tubular function
Pubmed
Web of science
Création de la notice
26/11/2018 14:37
Dernière modification de la notice
19/02/2020 7:19
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