Big equation for small kidneys: a newly proposed model to estimate neonatal GFR

Basalely, Abby; Liu, Diane; Kaskel, Frederick J.

doi:10.1007/s00467-019-04465-7

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…[16][17][18] Many small metabolites in cord blood are thus correlated with maternal levels during the third trimester. [12] For example, plasma creatinine, a marker of kidney function, largely reflects maternal levels when measured in cord blood [19], but has been linked to birth weight. [20,21] Maternal circulating bile acids, which may be influenced by maternal gut microbiota, may program offspring metabolism, or influence their microbiome, and have been linked to insulin resistance.…”

Section: Tweetmentioning

confidence: 99%

Prediction of type 1 diabetes at birth: cord blood metabolites versus genetic risk score in the MoBa cohort

Tapia

Suvitaival

Ahonen

et al. 2021

Preprint

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Background and aim Genetic markers are established as predictive of type 1 diabetes, but unknown early life environment is believed to be involved. Umbilical cord blood may reflect perinatal metabolism and exposures. We studied whether selected polar metabolites in cord blood contribute to prediction of type 1 diabetes. Methods Using a targeted UHPLC-QQQ-MS platform, we quantified 27 low molecular weight metabolites (including amino acids, small organic acids and bile acids) in 166 children, who later developed type 1 diabetes, and 177 random control children in the Norwegian Mother, Father and Child (MoBa) cohort. We analysed the data using logistic regression (estimating odds ratios per standard deviation [aOR]), area under the receiver operating characteristic curve (AUC) and k-means clustering. Metabolites were compared to a genetic risk score based on 51 established non-HLA SNPs, and a four-category HLA risk group. Results The strongest associations for metabolites were aminoadipic acid (aOR=1.23,95%CI:0.97-1.55), indoxyl sulfate (aOR=1.15,95%CI:0.87-1.51), and tryptophan (aOR=0.84,95%CI:0.65-1.10), with other aORs close to 1.0, and none significantly associated with type 1 diabetes. K-means clustering identified six clusters, none of which were associated with type 1 diabetes. Cross-validated AUC showed no predictive value of metabolites (AUC 0.49), while the non-HLA genetic risk score AUC was 0.56 and the HLA risk group AUC was 0.78. Conclusions In this large study, we found no support of a predictive role of cord blood concentrations of selected bile acids and other small polar metabolites in the development of type 1 diabetes.

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Section: Tweetmentioning

confidence: 99%

Prediction of type 1 diabetes at birth: cord blood metabolites versus genetic risk score in the MoBa cohort

Tapia

Suvitaival

Ahonen

et al. 2021

Preprint

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“…The clearance of Scr defines the volume of blood plasma that is cleared of creatinine per unit time and approximates the GFR. Many mathematical equations have been proposed to reflect creatinine clearance or estimated GFR in newborn infants, mostly by means of linear regression methods [4][5][6][7][8]. In classical linear regression, there is only one level of unexplained variability (difference between observation and predicted value).…”

Section: Introductionmentioning

confidence: 99%

Characterizing dynamics of serum creatinine and creatinine clearance in extremely low birth weight neonates during the first 6 weeks of life

et al. 2020

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Background Characterizing the dynamics of serum creatinine concentrations (Scr) and associated creatinine clearance (CLcr) as a measure of kidney function in extremely low birth weight (≤ 1000 g; ELBW) neonates remains challenging. Methods We performed a retrospective study that included longitudinal Scr (enzymatic assay) data from 148 ELBW neonates up to 6 weeks after birth. Change of Scr and inter-individual variability was characterized with nonlinear mixed-effect modeling. Key covariates such as gestational age (GA), mode of delivery (MOD), and treatment with ibuprofen or inotropic agents were investigated. Results A total of 2814 Scr concentrations were analyzed. GA was associated with Scr at birth (higher with advancing GA), and GA and MOD showed an association with postnatal maturation of CLcr (faster clearance increase with advancing GA and after C-section). Small CLcr decrease (≤ 5%) was quantified during ibuprofen treatment. For a GA of 27 weeks, mean Scr (estimated CLcr) at birth was 0.61 mg/dl (0.23 ml/min), increasing to 0.87 mg/dl (0.27 ml/min) at day three, and decreasing to 0.36 mg/dl (0.67 ml/min) at day 42 after birth. Conclusions We report the first mathematical model able to characterize Scr and CLcr in ELBW neonates during the first 6 weeks of life in a quantitative manner as a function of GA, MOD, and ibuprofen treatment. This model allows the derivation of GA-adjusted reference ranges for ELBW neonates and provides a rationale for normative Scr concentrations, and as such will help clinicians to further optimize monitoring and treatment decisions in this vulnerable patient population.

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“…Renal function is low at birth, (GFR ∼20-39 mL/min/1.73 m 2 ) with a continued rise during the first 4 weeks. E46 , E47 Factors contributing to the maturational increase in GFR include increase in filtration surface area and glomerular permeability as well as an increase in arterial pressure and renal blood flow. The literature shows high variability in the estimates of both effective renal plasma flow as well as GFR.…”

Section: Developmental Physiology Following Birth In Neonates With St...mentioning

confidence: 99%

Rapid bilateral pulmonary artery banding: A developmentally based proposal for the management of neonates with hypoplastic left heart

Wernovsky¹,

Öztürk²,

Diddle³

et al. 2023

JTCVS Open

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Big equation for small kidneys: a newly proposed model to estimate neonatal GFR

Cited by 7 publications

References 23 publications

Prediction of type 1 diabetes at birth: cord blood metabolites versus genetic risk score in the MoBa cohort

Prediction of type 1 diabetes at birth: cord blood metabolites versus genetic risk score in the MoBa cohort

Characterizing dynamics of serum creatinine and creatinine clearance in extremely low birth weight neonates during the first 6 weeks of life

Rapid bilateral pulmonary artery banding: A developmentally based proposal for the management of neonates with hypoplastic left heart

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