Physiological partial aldosterone resistance in human newborns

Martinerie, Laetitia; Pussard, Eric; Foix-L'Hélias, Laurence; Petit, Francois; Cosson, Claudine; Boileau, Pascal; Lombès, Marc

doi:10.1203/pdr.0b013e3181b1bbec

Cited by 148Renin-Angiotensin System StudiesHormonal Regulation and HypertensionElectrolyte and hormonal disorders

Physiological partial aldosterone resistance in human newborns

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Martinerie, Laetitia, Pussard, Eric, Foix-L'Hélias, Laurence, Petit, Francois, Cosson, Claudine, Boileau, Pascal, Lombès, Marc·2009·Pediatric Research

DOI 10.1203/pdr.0b013e3181b1bbecPMC PMC2919537

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Abstract

In the neonatal period, the human kidney is characterized by an impaired ability to regulate water and sodium homeostasis, resembling partial aldosterone resistance. The aim of our study was to assess this hormonal insensitivity in newborn infants and to determine its relationship with neonatal sodium handling. We conducted a prospective study in 48 healthy newborns and their mothers. Aldosterone, renin, and electrolyte concentrations were measured in umbilical cords and in maternal plasma. Urinary aldosterone concentrations and sodium excretion were determined at urination within 24 h after birth. A significant difference was observed between aldosterone and renin levels in newborn infants compared with their mothers (817 +/- 73 versus 575 +/- 55 pg/mL and 79 +/- 10 versus 15 +/- 2 pg/mL, respectively, p < 0.001). This hyperactivation of the renin-angiotensin-aldosterone system was associated with hyponatremia and hyperkalemia in the newborn infants, and high urinary sodium loss, consistent with a partial aldosterone resistance at birth. Unlike plasma aldosterone, urinary aldosterone concentration was found highly correlated with plasma potassium concentrations, thus representing the best index for accurate evaluation of mineralocorticoid sensitivity. Our study represents a comprehensive characterization of the renin-aldosterone axis in newborn infants and provides evidence for physiologic partial aldosterone resistance in the neonatal period.

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All infants affected with classic CAH benefit from glucocorticoid plus adjunctive mineralocorticoid treatment at least within the first year of life.
“All infants affected with classic CAH benefit from glucocorticoid plus adjunctive mineralocorticoid treatment at least within the first year of life, when there is relative renal tubular resistance to the salt-retaining effects of aldosterone in early infancy (28) and low sodium content of infant diets (29).”
From Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management (2022) · cites this paper as [28]

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Authors: Martinerie, L., Pussard, E., Foix-L'Hélias, L., Petit, F., Cosson, C., Boileau, P., & Lombès, M.
Affiliations: Université Paris-Sud (FR)
Assistance Publique – Hôpitaux de Paris (FR)
ORCID: Pussard, Eric
Foix-L'Hélias, Laurence
Petit, Francois
Boileau, Pascal
Lombès, Marc
Venue: Pediatric Research
Publisher: Springer Science and Business Media LLC
Published: 2009-09
Volume: 66
Issue: 3
Pages: 323-328
ISSN: 0031-3998 (ISSN-L)
1530-0447
DOI: 10.1203/pdr.0b013e3181b1bbec
PMC: PMC2919537
OpenAlex: W2033288210
Cited by: 148
References: 42
Citations by year: 2026: 4 · 2025: 6 · 2024: 31 · 2023: 9 · 2022: 10 · 2021: 7 · 2020: 3 · 2019: 11 · 2018: 4 · 2017: 15 · 2016: 11 · 2015: 4 · 2014: 9 · 2013: 6 · 2012: 6
FWCI: 3.88
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Pediatric Research (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
HAL (submittedVersion, other-oa)
Funders: Danone
Institut National de la Santé et de la Recherche Médicale
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
Keywords: neonates, renin-angiotensin-aldosterone system, urinary aldosterone, plasma aldosterone, renin, sodium homeostasis, water homeostasis, hyponatremia, hyperkalemia, plasma potassium, umbilical cord
MeSH terms: Adolescent, Adult, Aldosterone, Female, Humans, Hyperaldosteronism, Infant, Newborn, Middle Aged, Mineralocorticoids, Potassium, Prospective Studies, Renin, Renin-Angiotensin System, Sodium, Water-Electrolyte Balance, Young Adult

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Physiological partial aldosterone resistance in human newborns

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