Abstract
Background: Serum creatinine (SCr) is widely used to test renal function. SCr at birth is strongly affected by maternal SCr and does not reflect the renal function of the neonate. Serum cystatin C (CysC) has been used as an indicator of glomerular filtration rate in adults and children. However, CysC has not been widely used to evaluate kidney function in neonates until now. Methods: The renal function of neonates admitted to our neonatal intensive care unit was evaluated by analyzing cord blood CysC levels at birth using a latex immunoturbidimetric assay. Results: The cord blood CysC and SCr of ten neonates was measured at birth. The CysC levels of four patients without impaired renal function were between 1.26 and 1.53 mg/L. The CysC level in one case whose mother was diagnosed with chronic kidney disease was not elevated (1.60 mg/L), although the patient’s SCr level was elevated (2.25 mg/dL). The CysC levels of three patients with acute kidney injury due to asphyxia were slightly higher (1.78 to 2.17 mg/L) than those in patients without acute kidney disease. The CysC levels of two patients diagnosed with renal failure were substantially higher (4.09 and 7.07 mg/L) than those of patients without renal failure. Conclusion: CysC shows potential as a useful marker to evaluate the kidney function of neonates at birth, as CysC is not affected by maternal CysC.
Highlights
Detection of renal function in neonatal intensive care unit (NICU) is vital, because NICU mortality rates are stronglyStudy population and design: A single-center retrospective cohort study was performed at the Kurashiki Central Hospital (Kurashiki, Japan) from November 2016 to January 2018
Serum cystatin C (CysC) has been described as a promising biomarker of renal function, and several meta-analyses of recent studies favored CysC over Serum creatinine (SCr) for the detection of impaired Glomerular filtration rate (GFR) in almost all age groups [7,8], including neonates [9]
Other papers have reported that serum CysC in the first 3 postnatal days might be affected by maternal factors such as maternal serum CysC levels or body mass, as well as the maturation of infants
Summary
Detection of renal function in neonatal intensive care unit (NICU) is vital, because NICU mortality rates are strongly. Study population and design: A single-center retrospective cohort study was performed at the Kurashiki Central Hospital (Kurashiki, Japan) from November 2016 to January 2018 This pilot study was performed on patients who underwent cord blood CysC measurements at birth. Group A: Patients and their mothers had no renal function impairment. Group B: Patients had no renal impairment, but their mothers had CKD. Group C: Patients were diagnosed with AKI not requiring dialysis without maternal renal function impairment. Group D: Patients were diagnosed with renal failure requiring dialysis without maternal renal function impairment. CysC concentrations in cord blood and serum samples were analyzed using a latex immunoturbidimetric assay (N-assay LA Cystatin C, NITTOBO MEDICAL CO., Japan) and an automatic analyzer (LABOSPECT-008, Hitachi High-Technologies, Japan). SCr concentrations were analyzed using an enzyme assay (creatinase–sarcosine oxidase–peroxidase method) (L-Type Creatinine M, FUJIFILM Wako Pure Chemical CO., Japan) and an automatic analyzer (LABOSPECT-008, Hitachi High-Technologies, Japan) (Figures 1 and 2)
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