Angaben zum parenteralen Natriumbedarf gesunder Kinder streuen in Lehrbüchern um den Faktor 4. Daher wurde die Wirkung von 12-h-Infusionen mit niedrig- und hochdosiertem Na auf nierengesunde Kinder untersucht (Gr. 1: n = 13, Na 2,2 ± 0,4, K 2,0 ± 0,2, Cl 4, 1 ± 0,6mmol/kg/d, individuell gemischt; Gr. 2: n=17, Na 5,1 ± 1,3, K 1,6 ± 0,5, Cl 5,8 ± 1,5, Ca, Mg, Malat, Azetat, Glyzerinphosphat, käufliche Lösung). Während der Infusion blieb die Na-Ausscheidung im Urin im Vergleich zur 4-h-Vorperiode in Gr. 1 unverändert, sank dagegen in Gr. 2. Die Infusion von 2,7 mmol Na/kg/d hätte eine ausgeglichene Na-Bilanz ergeben. Der reelle parenterale Bedarf liegt niedriger, weil die Kinder vor der Untersuchung mit Na überladen waren. Während der Infusion blieb die Kreatinin-Clearance in Gr. 1 gleich, sank in Gr. 2 (131 ± 58 vs. 94 ± 38 ml/min/1,73 m2; p < 001). Die Fertiglösung sollte erst angewendet werden, wenn Mechanismus und klinische Bedeutung der Senkung der GFR aufgeklärt sind.

Keywords:
Natrium, Natriumbilanz, Glomeruläre Filtrationsrate
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© 1991 S. Karger AG, Basel
1991
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