Evaluation of Renal Function During Childhood

Atiyeh, Bassam; Dabbagh, Shermine; Gruskin, Alan B.

doi:10.1542/pir.17-5-175

Cited by 52 publications

(36 citation statements)

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“…In the clinical setting, GFR is most frequently estimated by creatinine clearance, which correlates with serum creatinine levels. Serum creatinine increases during childhood as a consequence of increased muscular mass, whereas creatinine clearance (ml/min per 1.73 m 2 ), increases rapidly during the first year of life and stabilizes thereafter (22).…”

Section: Discussionmentioning

confidence: 99%

Serum Creatinine Levels Are Significantly Influenced by Renal Size in the Normal Pediatric Population

Zazzo¹,

Stringini²,

Matteucci³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Clinical and experimental data have shown that differences in nephron endowment result in differences in renal mass and predisposition to chronic renal failure, hypertension, and proteinuria. We hypothesized that a significant proportion of the variance in GFR, as estimated by serum creatinine, is attributable to differences in renal size in normal children.Design, setting, participants, & measurements A total of 1748 normal renal ultrasounds that were performed in children older than 6 months were reviewed. For each ultrasound, serum creatinine, serum blood urea nitrogen, and systolic and diastolic office BP were recorded. Renal size was evaluated as a function of renal length and thickness. All data were normalized for height, weight, age, and gender.Results When expressed as SD scores, a significant correlation was found between kidney size and serum creatinine (P Ͻ 0.0001) and between kidney size and serum blood urea nitrogen (P Ͻ 0.002). When dividing kidney size data per quintiles, a difference of 0.51 SD score in serum creatinine was observed between the lowest and highest quintile. No significant correlation was found with office BP measurements.Conclusions These data show that, even in the normal pediatric population, differences in renal function are significantly explained by differences in renal mass. Methodologic limitations of this study are likely to underestimate this relationship.

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Section: Discussionmentioning

confidence: 99%

Serum Creatinine Levels Are Significantly Influenced by Renal Size in the Normal Pediatric Population

Zazzo¹,

Stringini²,

Matteucci³

et al. 2011

Clinical Journal of the American Society of Nephrology

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“…It has, therefore, been suggested that the diagnosis of renal dysfunction in preterm infants should be based on reference charts rather than on a single cutoff value during the early neonatal period. 2,3 While reference data are available for both term and moderately preterm infants, [4][5][6][7][8] there are limited data in extremely premature babies born at <28 weeks gestation, especially in the first few days of life. Available data suggest that creatinine levels in these babies are much higher than in more mature preterm babies during the first few days of life, decreasing thereafter to the normal term reference range.…”

Section: Introductionmentioning

confidence: 99%

A gestation- and postnatal age-based reference chart for assessing renal function in extremely premature infants

et al. 2008

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Objective: A single value of plasma creatinine cannot be used to define renal dysfunction in premature babies, as levels are influenced by gestation and postnatal age. The aim of this study was to create reference ranges for plasma creatinine in cohort of extremely premature infants.Study Design: Retrospective analysis of plasma creatinine levels in the first 8 weeks of life from 161 consecutively admitted premature infants 28 weeks gestation.Result: Babies were divided into three groups according to gestation. Peak (10th, 90th percentiles) creatinine levels were 132 (106,162) in 22 to 24 weeks gestational infants, 127 (89,151) in those from 25 to 26 weeks and 110 (87,134) in those from 27 to 28 weeks (P<0.001). Creatinine at birth was similar across the groups with levels increasing during the first few days. It decreases thereafter before reaching stable levels by 5 weeks of age.Conclusion: Gestation-and age-based reference charts should be used for interpretation of creatinine values in extremely premature babies.

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“…Serum Cr level is still widely used in current clinical studies to define neonatal AKI 6,7) despite its limitations of being influenced by maternal-fetal transplacental transfer, body mass, and maturation variability [8][9][10][11] . Furthermore, elevation of serum Cr level is a reflec tion of decreased renal function, not a marker of kidney injury.…”

Section: Discussionmentioning

confidence: 99%

“…For example, serum Cr levels can vary depending on age, gender, muscle mass, medication, and intravascular volume status 8) . Furthermore, elevation of serum Cr level is not a marker but a consequence of kidney injury.…”

Section: Introductionmentioning

confidence: 99%

“…In infants, using urine samples for NGAL measurement has a limitation because collecting urine for AKI evaluation is difficult owing to anuria, oliguria, or impaired urine-concentrating ability in infants 8) . To overcome such limitation in collecting urine sample, studies using blood NGAL measurement have been performed for several neonatal groups 13,17,22) .…”

Section: Introductionmentioning

confidence: 99%

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Clinical Utility of Rapid Plasma Neutrophil Gelatinase-Associated Lipocalin Assays for Diagnosing Acute Kidney Injury in Critically Ill Newborn Infants

Chung

Choi

et al. 2017

Neonatal Med

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Purpose: Neutrophil gelatinase-associated lipocalin (NGAL) has been identified as an early marker of acute kidney injury (AKI). This study was designed to evaluate the clinical utility of the rapid plasma NGAL assay for diagnosing AKI in critically ill newborn infants in the neonatal intensive care unit (NICU). Methods: The medical records of 178 critically ill newborn infants >34 weeks of gestational age who underwent plasma NGAL measurement during the first week of life in the Korea University Ansan Hospital NICU from February 2011 to August 2015 were retrospectively reviewed. Plasma NGAL levels were measured at bedside by using a commercial competitive immunoassay kit simultaneously with serum crea tinine (Cr) level determination. Results: Of 178 newborn infants enrolled in this study (study group), 25 infants had AKI (AKI group) while 153 infants had no AKI (control group). The plasma NGAL level in the AKI group (114.0 [76.5-281.5] ng/mL) was significantly higher than that in the control group (74.0 [52.5-122.5] ng/mL, P=0.001). Moreover, plasma NGAL levels were found to be correlated with serum Cr levels in the study group (r=0.208, P= 0.005). Plasma NGAL achieved an area under the receiver operating characteristic curve of 0.705 for detecting AKI (95% confidence interval: 0.593-0.817). The best cutoff plasma NGAL level for AKI diagnosis was 100 ng/mL. Conclusion: The rapid plasma NGAL assay has diagnostic value for AKI in critically ill newborn infants >34 weeks of gestational age. Further investigations with a larger population are needed to confirm the potential use of plasma NGAL levels for diagnosing AKI in newborn infants.

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Evaluation of Renal Function During Childhood

Cited by 52 publications

References 0 publications

Serum Creatinine Levels Are Significantly Influenced by Renal Size in the Normal Pediatric Population

Serum Creatinine Levels Are Significantly Influenced by Renal Size in the Normal Pediatric Population

A gestation- and postnatal age-based reference chart for assessing renal function in extremely premature infants

Clinical Utility of Rapid Plasma Neutrophil Gelatinase-Associated Lipocalin Assays for Diagnosing Acute Kidney Injury in Critically Ill Newborn Infants

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