Fetal renal response to atrial natriuretic factor decreases with maturation

Mechanisms of neonatal increase in glomerular filtration rate

To investigate the mechanisms responsible for the neonatal increase in glomerular filtration rate (GFR), renal function studies (whole kidney and micropuncture) were carried out in anesthesized fetal sheep (133–140 days gestation; term = 150 days) and lambs (12–18 days). Fetuses were delivered and placed in a water bath (39.5°C), keeping the umbilical cord moist and intact. Lambs were studied on a thermostatically controlled heating pad. Animals were prepared for either blood flow studies or micropuncture measurements. Expected differences in blood composition and cardiovascular and renal function were observed between fetuses and lambs, and values obtained for most variables were similar to those measured in chronically catheterized unanesthetized animals. Fetal GFR was much lower than that of lambs (0.20 vs. 0.62 ml·min−1·g kidney−1, P < 0.001). Free-flow, stop-flow, and net filtration pressures (NFP) were lower in the fetuses than the lambs (NFP 20.8 vs. 23.8 mmHg, P < 0.001), as was the calculated ultrafiltration coefficient (0.014 vs. 0.022 ml·min−1·g−1·mmHg−1, P < 0.001). Thus, we conclude that rises in both net filtration pressure and the ultrafiltration coefficient contribute to the large increase in GFR between fetal life and ∼2 wk after birth.

The effects of continuous drainage of fetal fluids on salt and water balance in fetal sheep

1. In nine chronically catheterized fetuses in which all lung liquid was drained continuously from the time of surgery, the effects of continuous drainage of fetal urine for 1 week on fetal renal function, lung liquid production and salt and water balance were studied. Fetal wellbeing, as judged by fetal growth, urinary osmolality, blood gas status, arterial pressure and heart rate, was not adversely affected by urine drainage. The ewes, however, drank more water when fetal urine was drained. Thus. fetal plasma and urinary osmolalities declined (P < 0.25 and P < 0.05). 2. Fetal glomerular filtration rate fell from 75 +/- 4 ml kg-1 h-1 (+/- S.E.M., n = 9) before drainage to 54 +/- 7 ml kg-1 h-1 after drainage (n = 7; P < 0.005), and fetal renal sodium excretion also declined (P < 0.05). However, the excretion of sodium in lung liquid did not decrease and the fetal renin-angiotensin system was not activated. Fetal extracellular volume (561 +/- 44 ml kg-1, n = 7) and the calculated net sodium transfer (0.76 mmol kg-1 h-1, n = 6) and fluid transfer (15 +/- 2 ml kg-1 h-1, n = 8) to the fetus did not change. 3. It is concluded that overall fetal salt and water balance were maintained when all fetal urine and lung liquid were drained from fetal sheep in late gestation. Since drainage of urine and lung liquid considerably reduced the amniotic and allantoic fluids, transfer across the placenta and extraplacental membranes was able to compensate for the absence of these fluids. In response to the loss of sodium during drainage, fetal renal sodium conservation was about 11% of the total sodium conservation by the materno-fetal unit.

Extracellular volume and blood volume in chronically catheterized fetal sheep

1. To determine the extracellular volume (ECV) in fetal sheep and its distribution between the plasma and interstitial spaces, ECV, blood volume (BV) and haematocrit were measured in ten chronically catheterized fetal sheep aged 121-133 days. Relationships with age, weight and other fetal variables, including glomerular filtration rate (GFR), were studied. 2. ECV was measured as the mean of the volumes of distribution of [3H]inulin and [14C]mannitol extrapolated to time zero. The time zero volume of distribution was 1506 +/- 79 ml (means +/- S.E.M.) for inulin and 1590 +/- 80 ml for mannitol. The ECV was 1548 +/- 79 ml (632 +/- 18 ml (kg fetal wt)-1). BV, measured using 51Cr-labelled red cells, was 351 +/- 27 ml (141 +/- 6 ml kg-1). Haematocrit, plasma volume and interstitial volume were 34 +/- 1%, 229 +/- 17 ml (92 +/- 3 ml kg-1) and 1319 +/- 63 ml (540 +/- 17 ml kg-1), respectively. 3. Interstitial volume per kilogram fell with increasing fetal weight (P = 0.026). BV per kilogram did not change with weight or age. 4. The plasma: interstitial volume ratio was 0.17 +/- 0.01. This ratio increased as fetal weight and age increased (P = 0.026 and P = 0.044), that is, the proportion of ECV that was contained outside the vascular compartment was lower in heavier or older fetuses. 5. Since GFR was 3.4 +/- 0.4 ml min-1, the entire fetal ECV was filtered by the fetal kidney only 3.1 +/- 0.3 times per day.