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

Zazzo, Giacomo Di; Stringini, Gilda; Matteucci, Maria Chiara; Muraca, Maurizio; Malena, S.; Emma, Francesco

doi:10.2215/cjn.00580110

Cited by 22 publications

(13 citation statements)

References 31 publications

(30 reference statements)

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“…23 In line with that study, we observed an inverse association of fetal kidney size with creatinine and cystatin C levels in childhood, and a positive association with eGFR. We previously observed that small fetal kidney size tends to track throughout early childhood.…”

Section: Discussionsupporting

confidence: 90%

Childhood Kidney Outcomes in Relation to Fetal Blood Flow and Kidney Size

Kooijman

Bakker

Heijden

et al. 2014

Journal of the American Society of Nephrology

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Impaired fetal abdominal blood flow may lead to smaller kidneys and subsequent impaired kidney function in later life. In a prospective cohort study among 923 pregnant women and their children, we measured fetal growth, kidney volumes, and umbilical and cerebral artery blood flow (median gestational age of 30.3 weeks; 95% range, 28.5-32.7 weeks). We used a higher umbilical/cerebral artery pulsatility index ratio as an indicator of preferential fetal blood flow to the upper body parts at the expense of the intra-abdominal organs. At a median age of 5.9 years (95% range, 5.7-6.6 years), we measured childhood kidney volumes, creatinine and cystatin C blood levels, microalbuminuria, BP, and eGFR. A preferential fetal blood flow to the upper body parts at the expense of the intra-abdominal organs associated only with a smaller combined kidney volume in childhood. Fetal combined kidney volume positively associated with childhood combined kidney volume and eGFR, and inversely associated with childhood creatinine and cystatin C levels (all P values ,0.05), but did not associate with childhood microalbuminuria and BP. Children within the highest tertile of fetal umbilical/ cerebral ratio and the lowest tertile of fetal combined kidney volume had the lowest eGFR (difference, 26.36 ml/min per 1.73 m 2 ; 95% confidence interval, 211.78 to 20.94 compared with children within the middle tertiles). These data suggest that impaired fetal blood to the abdominal organs and smaller fetal kidney size are associated with subclinical changes in kidney outcomes in school-aged children.

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Section: Discussionsupporting

confidence: 90%

Childhood Kidney Outcomes in Relation to Fetal Blood Flow and Kidney Size

Kooijman

Bakker

Heijden

et al. 2014

Journal of the American Society of Nephrology

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“…It is estimated that for every 1-kg increase in birth weight, glomeruli number increases by approximately 260,000 [7, 34]. Reduced nephron number is associated with compensatory mechanisms including glomerular hyperfiltration, which can ultimately lead to CKD; this process is exacerbated by hypertension [35, 36]. Potential mechanisms for the reduction in nephron number during gestation include alterations in DNA methylation, increased apoptosis in the developing kidney, renin-angiotensin system alterations, vitamin A and other nutritional deficiencies, and increased fetal glucocorticoid exposure [37, 38].…”

Section: Discussionmentioning

confidence: 99%

Race-specific relationship of birth weight and renal function among healthy young children

et al. 2012

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Background Low birth weight is associated with diminished renal function. However, despite African Americans being at increased risk of low birth weight and chronic kidney disease, little is known about the association between birth weight and renal function in diverse groups. We examined racial differences in the relationship of birth weight and renal function among healthy, young children. Methods Birth weight and serum creatinine were available on 152 children (61.8% African American; 47.4% female) from a birth cohort. Estimated glomerular filtration rate (eGFR) was calculated using the bedside Schwartz equation and gender- and gestational-age adjusted birth weight Z-scores using the US population as a reference. Race-specific linear regression models were fit to estimate the association between birth weight Z-score and eGFR. Results Mean age was 1.5±1.3 years at first eGFR measurement. African Americans had lower eGFR than non-African Americans (median eGFR= 82 vs. 95 mL/min per 1.73m2; P=0.06). Birth weight was significantly and positively associated with eGFR among African-American (P=0.012) but not non-African-American children (P=0.33). Conclusions We provide, for the first time, evidence suggesting birth weight is associated with renal function in African-American children. Future work is needed to determine if prenatal programming helps explain racial disparities in adult health.

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“…A recent study of 1 748 healthy children over 6 months of age established a close correlation between renal length and thickness, and creatinine [74]. Abitbol et al [75 && ] studied CysC, creatinine, and renal volume in premature neonates and concluded that CysC was a better marker of neonatal GFR.…”

Section: Can We Use the Renal Volume As Marker Of Glomerular Filtratimentioning

confidence: 99%