Reference ranges for plasma creatinine during the first month of life.

Rudd, P T; Hughes, Elizabeth; Placzek, Monica; Hodes, D T

doi:10.1136/adc.58.3.212

Cited by 93 publications

(50 citation statements)

References 11 publications

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“…They were by definition of their prematurity not in a stable physiologic state and without performing inulin clearance studies we cannot say for certain that their renal function was normal. However, the creatinine levels on day 2 are similar to those widely quoted elsewhere, 4,5 and none of our infants went on to develop renal failure. Although not physiologically stable, our study is exactly the patient population in whom clinicians will be trying to interpret the significance of high plasma creatinine levels.…”

Section: Discussionsupporting

confidence: 60%

“…5 Our results show that even in the most premature infants, plasma creatinine at the time of birth reflects normal maternal levels. Creatinine rises significantly to a peak around the second day of life before falling steadily in the manner described by Rudd et al 4 and Bueva and Guinard. 5 We have demonstrated that the most premature infants have a higher peak in plasma creatinine and that the subsequent fall in creatinine occurs later than in more mature infants.…”

Section: Discussionmentioning

confidence: 63%

“…Currently available reference data for plasma creatinine in the first month of life 4,5 support the belief that creatinine falls steadily during this period from levels that are initially higher in preterm infants. 12 Until recently, no published data explained the high levels seen shortly after birth in the preterm infant.…”

Section: Discussionmentioning

confidence: 94%

“…Rises in plasma creatinine concentration of Ͼ20 mol/L a day have been thought to imply impending renal failure. 3 The best reference data available 4,5 show that initial creatinine levels in preterm infants are higher than expected and that they take longer to fall to steady state levels. There has been speculation that these high initial levels reflect higher maternal creatinine concentration.…”

mentioning

confidence: 99%

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Plasma Creatinine Rises Dramatically in the First 48 Hours of Life in Preterm Infants

Miall¹,

Henderson²,

Turner³

et al. 1999

Pediatrics

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ABSTRACT.Objective. Published data show that plasma creatinine falls steadily during the first 28 days of life and that creatinine levels in the neonatal period are higher in more premature infants. However, the best reference data commence on day 2 of life. The objective of this study was to document how plasma creatinine changes in the first 48 hours of life and to examine the reason for the apparently high levels of creatinine in preterm infants, compared with maternal levels.Design. A prospective observational study on a regional neonatal intensive care unit.Patients. A total of 42 preterm infants, mean gestational age of 29.4 weeks (range: 23-35), mean birth weight of 1.42 kg (.55-2.77), divided into 4 gestation groups: 23 to 26 weeks (n ‫؍‬ 9), 27 to 29 weeks (n ‫؍‬ 13), 30 to 32 weeks (n ‫؍‬ 12), and 33 to 35 weeks (n ‫؍‬ 8).Interventions. Measurement of plasma creatinine and urea concentration in cord blood and in serial samples taken for routine arterial blood gas analysis.Outcome Measurements. Changes in creatinine concentration with time and relationship to gestational age, birth weight, and illness severity. Conclusions. Rather than falling steadily from birth, creatinine rises dramatically in the first 48 hours of life, especially in infants of <30 weeks' gestation. Even large rises in creatinine in the first 48 hours may be expected and should not be used in isolation to diagnose renal failure. Pediatrics 1999;104(6). URL: http://www. pediatrics.org/cgi/content/full/104/6/e76; creatinine, preterm infant, renal failure.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 94%

mentioning

confidence: 99%

See 2 more Smart Citations

Plasma Creatinine Rises Dramatically in the First 48 Hours of Life in Preterm Infants

Miall¹,

Henderson²,

Turner³

et al. 1999

Pediatrics

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“…The higher creatinine values in our growth-retarded twins, were within the normal range (Rudd et al, 1983) and no distinguishing line for evidence of a uterine-placental compromise could be drawn. This finding is not unexpected since the growth retarded twins had good Apgar scores and did not seem to suffer from stressful conditions of high severity prior to delivery.…”

Section: Resultsmentioning

confidence: 99%

Early Plasma Creatinine Values in Discordant Twins

Arad¹,

Bar‐Oz²,

Peleg³

2001

Twin Research

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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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Reference ranges for plasma creatinine during the first month of life.

Cited by 93 publications

References 11 publications

Plasma Creatinine Rises Dramatically in the First 48 Hours of Life in Preterm Infants

Plasma Creatinine Rises Dramatically in the First 48 Hours of Life in Preterm Infants

Early Plasma Creatinine Values in Discordant Twins

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

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