Neonatal and maternal serum creatinine levels during the early postnatal period in preterm and term infants

Go, Hayato; Momoi, Nobuo; Kashiwabara, Nozomi; Haneda, Kentaro; Chishiki, Mina; Imamura, Takashi; Sato, Maki; Goto, Aya; Kawasaki, Yukihiko; Hosoya, Mitsuaki

doi:10.1371/journal.pone.0196721

Cited by 40 publications

(24 citation statements)

References 27 publications

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“…Similar to the findings by Go et al [4], we observed a positive correlation of S cr at birth with GA (week, in the absence of data on days) in a large, pooled, and heterogeneous cohort (882 S cr observations, GA range 23–42 weeks) of neonates [4, 6, 7]. Although statistically significant, the clinical impact of this positive correlation is rather limited (24–40 weeks, 54.5–60.2 μmol/L, +10%).…”

Section: Resultssupporting

confidence: 92%

“…Using an enzymatic assay for S cr measurement, Go et al [4] reported that the aforementioned fetal/maternal ratio increases with GA ( r = 0.71). The median neonatal S cr values were higher than maternal values from 29 weeks GA onward due to differences in trend patterns in neonatal (increase with advancing GA) and the stable median maternal S cr throughout the gestation [4, 5]. Using a systematic search and pooled analysis, Wiles et al [5] recently reported on maternal mean S cr reference values throughout pregnancy.…”

Section: Introductionmentioning

confidence: 99%

“…The mean maternal S cr was 56, 52, and 54 μmol/L in the first, second, and third trimester of pregnancy (corresponding to 84, 77, and 80% of the mean nonpregnant value, respectively) without clear trends throughout gestation [5]. Because reference values and trends are of scientific and clinical relevance to assess and quantify acute kidney injury (AKI), we pooled 2 earlier reported S cr datasets (all enzymatic) in neonates to explore the covariates of S cr , with specific interest in early neonatal (first week) life [4-7].…”

Section: Introductionmentioning

confidence: 99%

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Creatinine at Birth Correlates with Gestational Age and Birth Weight: Another Factor of the Imbroglio in Early Neonatal Life

et al. 2020

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Background: Serum creatinine (Scr) in early neonatal life (first week of life) displays extensive variability; hence, a better understanding is needed to use Scr as a diagnostic biomarker for acute kidney injury (AKI). Objective: The objective of this study was to explore Scr trends and its covariates in early neonatal life. Methods: Analysis of a rich, pooled Scr dataset (enzymatic assay) of 4,509 Scr observations in 1,181 neonates in the first week of life with birth weight, gestational age (GA), and postnatal age as covariates was conducted. Descriptive data were summarized as median and range. The Spearman rank correlation test was used to examine Scr, while the Mann-Whitney U test was used to determine the differences between the different GA (≤32, 33–36, or ≥37 weeks) categories. Results: The median Scr at delivery was 55.7 (range 28.3–194.5) µmol/L, correlating with birth weight (r = 0.088) or GA (r = 0.183) for the full dataset. At birth, the median Scr was highest in term (≥37-week) neonates. In early neonatal life (median Scr values), there was a gradual increase to attain a peak Scr by day 2–3, highest and most delayed in neonates ≤32 weeks GA. This is followed by a blunted decrease when ≤32-week neonates were compared to those of 33–36 or ≥37 weeks GA. Conclusions: The Scr pattern in early neonatal life is complex, with the highest Scr at birth in full-term neonates, while those ≤32 weeks GA displayed the highest and delayed peak Scr with a subsequent blunted decrease. Knowledge of these patterns is crucial to explore the utility of Scr as an AKI biomarker.

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Section: Resultssupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Creatinine at Birth Correlates with Gestational Age and Birth Weight: Another Factor of the Imbroglio in Early Neonatal Life

et al. 2020

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“…ELBW neonates who are born in the third trimester (> 28 weeks) were characterized by higher Crea birth Scr (median (95% CI); 0.79 mg/dl (0.50–1.29) at 32 weeks GA). This trend is also, albeit to a lesser extent, reflected by the maternal creatinine concentrations, which are generally, but marginally lower during the second trimester (0.59 mg/dl) as compared with the third trimester (0.61 mg/dl) [ 21 ].…”

Section: Discussionmentioning

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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“…The present study also showed a moderate positive correlation of GFR with gestational age and anthropometric parameters. Whereas studies with inulin [33] and serum creatinine [34] demonstrated the correlation between gestational age and GFR, most studies done using Cystatin C have reported contrary findings [35,36]. This finding also suggested the need to considered a new formula for estimate GFR in the newborns that will incorporate anthropometric indices.…”

Section: Discussionmentioning

confidence: 99%

Determination of glomerular filtration rate using cystatin C in healthy Nigerian newborns

Ibrahim

Soladoye

Adedoyin

et al. 2019

Alexandria Journal of Medicine

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Background: The value of Cystatin C as a biomarker of Glomerular filtration rate (GFR) among African newborns is unknown, due to paucity of studies, restricting the measurement of GFR in this population of newborns to creatinine clearance despite its limitations. This study was therefore conducted to estimate GFR from serum Cystatin C in a population of Nigerian newborns and explored the relationship with anthropometrics. Methods: This was a cross-sectional, analytical study. A total of 60 healthy preterm and 30 healthy term babies were recruited at a tertiary hospital in North-central, Nigeria. Serum Cystatin C was determined using ELISA according to standard methods. Anthropometric measurements were done with standard methods. The GFR was estimated using Zappitelli's equation. Data were analyzed using SPSS Version 20, and p-value < 0.05 was considered significant. Results: Mean serum Cystatin C was 1.20 ± 0.33 (range 0.80-2.20) mg/L with comparable values in males and females (1.19 ± 0.35 vs 1.15 ± 0.31 mg/L, p = 0.481)). Mean serum Cystatin C among preterm babies were higher than term babies (1.31 ± 0.36 vs 1.01 ± 0.11 mg/L, p = < 0.001). Mean estimated GFR was 65.36 ± 16.9 ml/min/1.73 2 and was comparable in males and females (64.39 ± 17.95 vs 66.52 ± 15.76 ml/min/1.73 m 2 ,p = 0.555). Estimated GFR was lower among preterm than term babies (60.10 ± 17.53 vs 75.89 ± 9.1 ml/min/1.73 m 2 , p = < 0.001). Serum cystatin C and estimated GFR moderately correlated with gestational age and anthropometrics (length, occipitofrontal circumference and weight). Conclusions: Serum cystatin C as a biomarker GFR among newborns is low compared with most studies done out of Africa. The serum cystatin C and estimated GFR correlated with the gestational age and anthropometric parameters. The findings relationship between the serum Cystatin C, estimated GFR and anthropometrics among the newborns suggested a need for more studies. ARTICLE HISTORY

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Neonatal and maternal serum creatinine levels during the early postnatal period in preterm and term infants

Cited by 40 publications

References 27 publications

Creatinine at Birth Correlates with Gestational Age and Birth Weight: Another Factor of the Imbroglio in Early Neonatal Life

Creatinine at Birth Correlates with Gestational Age and Birth Weight: Another Factor of the Imbroglio in Early Neonatal Life

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

Determination of glomerular filtration rate using cystatin C in healthy Nigerian newborns

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