Aldosterone-Signaling Defect Exacerbates Sodium Wasting in Very Preterm Neonates: The Premaldo Study

The Journal of Clinical Endocrinology and Metabolism
Laetitia MartineriePascal Boileau

Abstract

The neonatal period, notably in preterm infants, is characterized by high sodium wasting, implying that aldosterone, the main hormone regulating sodium reabsorption, is unable to maintain sodium homeostasis. This study sought to assess aldosterone secretion and action in neonates according to gestational age (GA). This was a multicenter prospective study (NCT01176162) conducted between 2011 and 2014 at five neonatology departments in France. Infants were followed during their first 3 months. The 155 newborns included were classified into three groups: Group 1 (n = 46 patients), <33 gestational weeks (GW); Group 2 (n = 67 patients), 33-36 GW; and Group 3 (n = 42 patients), ≥37 GW. Plasma aldosterone was measured in umbilical cord blood. Urinary aldosterone (UAldo) was assessed at day 0, day 3, month 1, and month 3 postnatal. The correlation between UAldo and the urinary Na/K ratio was determined as an index of renal aldosterone sensitivity. UAldo significantly increased with GA: from 8.8 ± 7.5 μg/mmol of creatinine (Group 1) to 21.1 ± 21.0 (Group 3) in correlation with plasma aldosterone levels in all groups (P < .001), demonstrating its reliability. The aldosterone/renin ratio significantly increased with GA, suggesting an aldo...Continue Reading

Associated Clinical Trials

Citations

Jun 16, 2016·Molecular and Cellular Endocrinology·Alexandre NaccacheMireille Castanet
Jan 20, 2017·Molecular and Cellular Pediatrics·Amelie StritzkeAbhay Lodha
Jul 28, 2017·Archives of Disease in Childhood. Fetal and Neonatal Edition·Simon TraversEric Pussard
Dec 11, 2019·American Journal of Physiology. Endocrinology and Metabolism·Simon TraversMarc Lombès
Jan 25, 2020·Experimental & Molecular Medicine·Laurence DumeigeLaetitia Martinerie
Jul 14, 2019·European Journal of Pediatrics·Caroline StoreyLaetitia Martinerie
Feb 23, 2019·Frontiers in Endocrinology·Andreas YiallourisElizabeth O Johnson
Jul 5, 2017·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Randall D JenkinsDavid J Rozansky
Jun 3, 2021·International Journal of Molecular Sciences·Margaux LaulhéLaetitia Martinerie
Jul 2, 2021·Molecular and Cellular Endocrinology·Say ViengchareunLaetitia Martinerie
Jul 4, 2021·Molecular and Cellular Endocrinology·Antoine-Guy LopezEstelle Louiset

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