Renal response in low-birth-weight neonates. Results of prolonged intake of two different amounts of fluid and sodium.

Changes in renal function and extracellular fluid volume during the first ten days of life were studied in two groups of low-birth-weight neonates receiving different fluid and sodium intakes from the third to the tenth day. Group 1 neonates received less fluid and sodium and fewer calories than group 2 neonates. Renal function and inulin space were measured before (day 2) and after (day 8) the neonates received the different fluid and sodium managements. Group 2 neonates (on the eight day) had less weight loss, lower plasma sodium and osmolal concentrations, and a similar inulin space per kilogram of body weight as on day 2. Group 1 neonates had more weight loss and a smaller inulin space on day 8 compared with day 2. Low-birth-weight neonates receiving high fluid and sodium loads from days 2 through 8 did not have a contraction of extracellular fluid volume as did those receiving lower fluid and sodium intakes during this period; as a result, the former group had a dilutional decrease in the plasma sodium level and osmolality.