Abstract
Background: Kidney function in preterm newborns may be impaired by many factors. Methods: 71 newborns with gestational age (GA) < 32 weeks were enrolled. Serum creatinine (sCr), cystatin C (CysC), beta-trace protein (BTP) and urea were measured at T0 (3rd day of life) and T36 (GA 36 weeks), and estimated glomerular filtration rate (eGFR) was calculated according to different formulas at T36. Pre-natal and post-natal kidney injury risk scores were calculated. Results: Newborns with GA ≤ 28 weeks had higher sCr at T0, and lower sCr, BTP and higher urea levels at T36 (p = 0.007, p = 0.005 and p = 0.029, respectively). eGFR values were not different according to GA when calculated by the formulas using only CysC, but were higher in subjects with GA ≤ 28 weeks according to the other formulas. The post-natal score was positively correlated with eGFR according to sCr-based formulas, but the correlations did not persist when adjusted for urea levels and GA. Conclusions: CysC-based eGFR values are not influenced by GA. Post-natal score shows a direct correlation with eGFR according to sCr-based formulas, not persisting after adjustment for GA and urea levels, implying the importance of the nutritional status, since more premature subjects receive a more aggressive nutritional regimen, testified by higher urea levels.
Highlights
The survival of preterm newborns has dramatically improved in the recent decades, with babies born as young as 25-week gestation having up to the 80% chance of survival [1]
EGFR values estimated by other formulas were higher in subjects born at a lower gestational age (GA)
At the 3rd day of life, cystatin C (CysC) and beta-trace protein (BTP) levels in our Neonatal Intensive Care Unit (NICU) population were comparable to the reference ranges previously reported for premature infants of similar GA [9,26], with only serum creatinine (sCr) values negatively correlated with GA
Summary
The survival of preterm newborns has dramatically improved in the recent decades, with babies born as young as 25-week gestation having up to the 80% chance of survival [1]. Preterm birth has a potential detrimental influence on kidneys developmental programming. Preterm birth may negatively impact on nephron endowment. The most used endogenous biomarker for the assessment of neonatal kidney function is serum creatinine (sCr). In childhood it is dependent on age, gender and muscle mass. New potential endogenous biomarkers have been proposed, such as cystatin C (CysC) [4] and beta-trace protein (BTP) [5]. Kidney function in preterm newborns may be impaired by many factors
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