腎再吸収能よりみた未熟児の無機リンの補充量に関する検討

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  • The supplementary phosphorus be provided for the capacity to reabsorb in organic phosphorus in premature neonates.

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To prevent metabolic bone diseases in premature neonates, a sufficient supply not only of vitamin D but also of calcium and phosphorus is of major importance. In order to determine the required level of phosphorus, the phosphorus concentration in umbilical cord blood and in the blood of a week-old infant, the phosphorus concentration in the urine directly after birth, and the %TRP were measured. The capacity to reabsorb inorganic phosphorus was also studied using brush border membrane vesicle from tubular epithelium in the kidneys.<BR>1 The concentration of inorganic phosphorus in umbilical cord blood was twice as high as the blood concentration in week-old infants.<BR>2 The concentration of inorganic phosphorus in the urine 24 hours after birth was negligible in neonates born after 32 gestational weeks or more.<BR>3 The capacity to reabsorb inorganic phosphorus was studied using brush border membrane from tubular epithelium in the kidneys.<BR>1) The reabsorption mechanism displayed sodium dependent active transport.<BR>2) Reabsorption of inorganic phosphorus was found from about the 24th week of pregnancy, and at 32 weeks it reached the same level as at full term delivery.<BR>As a result of these findings, we concluded that it is necessary to provide supplementary phosphorus to small premature neonates, particularly those that are breast-fed, even if the blood concentration of phosphorus is normal.<BR>For premature neonates whose adjusted number of gestational weeks at the time of birth is 32 weeks or less, other indications must be taken into account and supplementary phosphorus be provided even if the % TRP is low.

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