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DIAGNOSIS OF RENAL FAILURE IN THE NEWBORN

Diagnosis of renal failure in newborn infants is difficult due to immaturity of the kidney and technical factors. Utilization of urine to plasma ratios of urea (U/P U), creatinine (U/P Cr), sodium (U/P Na), and fractional sodium excretion (FE/Na) obviate the use of timed urine collections. FE/Na is calculated as:Measurement of U/P Na, U/P Cr or U/P U and FE/Na were performed in 11 premature and full term infants with demonstratable renal failure, and in 9 infants of various gestational ages with pre-renal oliguria.One patient with renal failure had FE/Na values below 3-5. and no infant with pre-renal oliguria had values above 3-5- However, 2 infants with renal failure had U/P U values above 11 and 4 infants with ollguria had values less than 11. FE/Na appears to be a useful adjunct to diagnosis of renal failure in the newborn and appears to be better than U/P U alone.