Symposium on Paediatric Anaesthesia and Intensive Care: Renal Physiology in Children

Abstract

The human kidney may not reach functional maturity until the age of 18 months. In the preceding months there are limitations in response to such stresses as salt and water loading, acidosis and dehydration. It is seen that these limitations must not be taken out of context of the overall situation of health or disease and of actual solute load. Almost all drug dosages for children are calculated on the basis of body size, and it should be recalled that in the first months of life there exists relative renal insufficiency on the basis of body weight or surface area in comparison with older children and adults. Precise physiologic data are necessary for completely successful management of the critically ill patient. It is seen from this review that not only are there gaps in our knowledge of developmental renal physiology, but also the process of development has introduced another variable into the evaluation of the individual patient.