1. Physiological partial aldosterone resistance in human newborns.: Aldosterone resistance at birth
- Author
-
Claudine Cosson, Eric Pussard, Laetitia Martinerie, François Petit, Laurence Foix-L’Hélias, Pascal Boileau, Marc Lombès, Récepteurs stéroïdiens : physiopathologie endocrinienne et métabolique, Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR93-Université Paris-Sud - Paris 11 (UP11), Service de génétique moléculaire, pharmacogénétique et hormonologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Service de Pédiatrie et Réanimations néonatales [Béclère], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de biochimie-hormonologie [Béclère], Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Service de Biochimie [Bicêtre], Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, and Service d'Endocrinologie et Maladies de la reproduction
- Subjects
Hyperkalemia ,MESH: Renin ,Renin-Angiotensin System ,chemistry.chemical_compound ,0302 clinical medicine ,MESH: Renin-Angiotensin System ,Renin ,MESH: Sodium ,Prospective Studies ,Aldosterone ,0303 health sciences ,MESH: Middle Aged ,MESH: Infant, Newborn ,[SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism ,Middle Aged ,Water-Electrolyte Balance ,Hyperaldosteronism ,MESH: Hyperaldosteronism ,MESH: Young Adult ,Female ,medicine.symptom ,Hyponatremia ,Adult ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Sodium ,chemistry.chemical_element ,030209 endocrinology & metabolism ,Article ,03 medical and health sciences ,Young Adult ,Internal medicine ,Mineralocorticoids ,Renin–angiotensin system ,medicine ,Humans ,030304 developmental biology ,MESH: Adolescent ,MESH: Humans ,business.industry ,Infant, Newborn ,MESH: Aldosterone ,MESH: Adult ,medicine.disease ,MESH: Prospective Studies ,Endocrinology ,chemistry ,MESH: Mineralocorticoids ,Mineralocorticoid ,Pediatrics, Perinatology and Child Health ,MESH: Potassium ,MESH: Water-Electrolyte Balance ,Potassium ,business ,MESH: Female ,Homeostasis - Abstract
International audience; 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.
- Published
- 2009
- Full Text
- View/download PDF