Î²-trace protein may be a more suitable marker of neonatal renal function

Filler, Guido; Lopes, Laudelino Marques; Harrold, JoAnn; Bariciak, Erika

doi:10.5414/cn108089

Cited by 26 publications

(29 citation statements)

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“…During the first few days of life, serum creatinine reflects maternal renal function [23,26,27]. Up to 72 h after birth, there is a strong correlation between maternal and newborn creatinine [41].…”

Section: Measurement Of Renal Functionmentioning

confidence: 96%

“…Increased serum B2M concentrations have recently been associated with respiratory distress syndrome when compared with healthy control newborns, questioning the feasibility of B2M to serve as a marker of neonatal GFR [68]. Questions have been posed as to whether CysC truly does not cross the placenta [23]. Mothers have increased CysC concentrations toward the end of the pregnancy [69,70].…”

Section: Alternative Endogenous Biomarkers Of Glomerular Filtration Ratementioning

confidence: 98%

“…It is unclear how the placenta transports CysC. Nonetheless, the proportion of CysC reflected by maternal CysC concentrations is small [23]. CysC is thus fundamentally different from serum creatinine as only minimal amounts cross the placenta, thereby reflecting mostly neonatal function [72].…”

Section: Alternative Endogenous Biomarkers Of Glomerular Filtration Ratementioning

confidence: 99%

“…The placenta primarily handles creatinine in the newborn. Creatinine is transported across the placenta [23] and this transport is bidirectional and mostly by simple perfusion. Transport is passive from mother to fetus across the placenta [24,25].…”

Section: Antenatal Kidney Development and Creatinine Handling Before mentioning

confidence: 99%

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Assessment of glomerular filtration rate in the neonate

Filler

Guerrero-Kanan

Álvarez-Elías

2016

Current Opinion in Pediatrics

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Section: Measurement Of Renal Functionmentioning

confidence: 96%

Section: Alternative Endogenous Biomarkers Of Glomerular Filtration Ratementioning

confidence: 98%

Section: Alternative Endogenous Biomarkers Of Glomerular Filtration Ratementioning

confidence: 99%

Section: Antenatal Kidney Development and Creatinine Handling Before mentioning

confidence: 99%

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Assessment of glomerular filtration rate in the neonate

Filler

Guerrero-Kanan

Álvarez-Elías

2016

Current Opinion in Pediatrics

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“…Another potential low-molecular-weight protein marker is beta-trace protein (BTP) [37]. BTP may be a superior marker for neonates as it does not seem to cross the placenta [38]. However, BTP measurement as a surrogate for eGFR is not widely available, and the modification of CysC by maternal function is modest.…”

Section: Is Cysc the Best Marker Of Neonatal Renal Function?mentioning

confidence: 99%

A step forward towards accurately assessing glomerular filtration rate in newborns

Filler

2015

Pediatr Nephrol

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In this edition of Pediatric Nephrology, Milena Treiber and colleagues have published a study on cystatin C (CysC) concentrations in relation to renal volumetry in 50 small-for-gestational age (SGA) and 50 appropriate-for-gestational age (AGA) neonates, deriving a new formula for estimating neonatal glomerular filtration rate (GFR). The study builds on previous work which established that renal volumetry together with CysC blood levels is a superior method for establishing GFR in term and pre-term newborns [The Journal of Pediatrics (2014) 164:1026-1031.e2]. Treiber et al. use the expected difference between SGA and AGA renal volumes to document the superiority of their new formula, which is based on total renal volume, CysC and body surface area, but does not incorporate gold-standard inulin clearance. Treiber et al.'s study adds new knowledge to the field that will hopefully improve the safety of renally excreted critical dose drugs in the newborn period. This editorial discusses the strengths and limitations of the current study.

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Markers of Kidney Function in Early Childhood and Association With Maternal Comorbidity

et al. 2022

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ImportanceKidney functional capacity is low at birth but doubles during the first 2 weeks of life and reaches near-adult levels at age 1 to 2 years. Existing reference intervals for markers of kidney function in newborns are mostly based on preterm newborns, newborns with illness, or small cohorts of term newborns, and the consequences of maternal comorbidities for newborn kidney function are sparsely described.ObjectiveTo establish robust reference intervals for creatinine and urea in healthy children in early childhood and to assess whether maternal comorbidity is associated with newborn creatinine and urea concentrations.Design, Setting, and ParticipantsThis multicenter, prospective, population-based cohort study assessed data and umbilical cord blood samples from participants in the Copenhagen Baby Heart Study (CBHS) who were born between April 1, 2016, and October 31, 2018, and venous blood samples from a subsample of CBHS participants who were enrolled in the COMPARE study between May 3, 2017, and November 4, 2018. Cord blood samples of 13 354 newborns from the CBHS and corresponding venous blood samples of 444 of those newborns from the COMPARE study were included. Blood samples were collected at birth, age 2 months, and age 14 to 16 months, with follow-up completed on February 12, 2020. Healthy nonadmitted term newborns from maternity wards at 3 hospitals in the Capital Region of Denmark were included.ExposuresMaternal comorbidity.Main Outcomes and MeasuresCreatinine and urea concentrations.ResultsAmong 13 354 newborns in the CBHS cohort, characteristics of 12 938 children were stratified by sex and gestational age (GA). Of those, 6567 children (50.8%) were male; 5259 children (40.6%) were born at 37 to 39 weeks’ GA, and 7679 children (59.4%) were born at 40 to 42 weeks’ GA. Compared with children born at 40 to 42 weeks’ GA, those born at 37 to 39 weeks’ GA had lower birth weight, Apgar scores at 5 minutes, placental weight, and placental-fetal weight ratio. Children born at 37 to 39 weeks’ GA vs those born at 40 to 42 weeks’ GA were more frequently small for GA at birth and more likely to have placental insufficiency and exposure to maternal preeclampsia, maternal diabetes, maternal kidney disease, and maternal hypertension. Among children born at 37 to 39 weeks’ GA, reference intervals were 0.54 to 1.08 mg/dL for creatinine and 5.32 to 14.67 mg/dL for urea; among children born at 40 to 42 weeks’ GA, reference intervals were 0.57 to 1.19 mg/dL for creatinine and 5.60 to 14.85 mg/dL for urea. At birth, multifactorially adjusted odds ratios among children exposed to preeclampsia were 9.40 (95% CI, 1.68-52.54) for a venous creatinine concentration higher than the upper reference limit, 4.29 (95% CI, 1.32-13.93) for a venous creatinine concentration higher than the 90th percentile, and 3.10 (95% CI, 1.14-8.46) for a venous creatinine concentration higher than the 80th percentile.Conclusions and RelevanceIn this study, improved reference intervals for creatinine and urea concentrations were generated. Preeclampsia was associated with an increased risk of high newborn creatinine concentrations, suggesting that newborns of mothers with preeclampsia need closer observation of their kidney function.

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Î²-trace protein may be a more suitable marker of neonatal renal function

Abstract: Maternal Cr and CysC may both cross the placenta while BTP may not. Placental crossing of Cr seems to be independent of gestational age. The reasons for the different placental handling of BTP and CysC remain unknown.

Cited by 26 publications

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Assessment of glomerular filtration rate in the neonate

Assessment of glomerular filtration rate in the neonate

A step forward towards accurately assessing glomerular filtration rate in newborns

Markers of Kidney Function in Early Childhood and Association With Maternal Comorbidity

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