Postnatal Adjustment in Renal Function

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Abstract
Renal function was studied serially in 17 healthy term infants during the hours immediately following birth. Of 14 infants delivered vaginally 8 received placental blood transfusion and 6 did not. The remaining 3 infants were delivered by cesarean section and received placental blood transfusion. The general pattern of change in urine output (V), clearance of inulin (CIN) and p-aminohippuric acid (CPAH) was similar in all infants despite a wide range in each of the functions measured. The pattern showed an initial increase in V, CIN, and CPAH followed by a decline to low values in all infants by 3 h of age. Urine osmolality and output generally changed in opposite directions. During the 1st h the values for V ranged from 0.02-0.47 ml/min; for CIN, from 0.5-9.1 ml/min; for CPAH, from 1.4-21.8 ml/min; and for osmolality, from 98-457 mOsm/kg. By 4 h of age the values for V ranged from 0.01-0.15 ml/min; for CIN, from 0.8-3.7 ml/min; for CPAH, from 0.8-7.5 ml/min; and for osmolality, from 240-520 mOsm/kg. The initial values of V, CIN, and CPAH, as well as the changes, were greatest in infants who received a placental transfusion; there were no statistical differences among the means of the various groups. By 4 h of age the range of values observed in the initial measurement was much less pronounced. This probably reflects the achievement of stability of renal circulation following adaptation to a variety of stresses during the intrapartum period.

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