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Pediatric Nephrology

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01-11-2017 | Original Article

Association between cord blood cystatin C levels and early mortality of neonates with congenital abnormalities of the kidney and urinary tract: a single-center, retrospective cohort study

Authors: Seiichi Tomotaki, Katsuaki Toyoshima, Tomoyuki Shimokaze, Jun Shibasaki, Hiroyuki Nagafuchi

Published in: Pediatric Nephrology | Issue 11/2017

Abstract

Background

Some fetuses with congenital abnormalities of the kidney and urinary tract (CAKUT) have severe renal dysfunction during the prenatal period that can result in oligohydramnios, pulmonary hypoplasia, and death following birth. We hypothesized that cord blood cystatin C (CysC) levels are elevated in neonates who have life-threatening pulmonary hypoplasia and oligohydramnios due to severe renal dysfunction. In this study we compared cord blood CysC levels between a non-survivor group with CAKUT and a survivor group.

Methods

This was a single-center, retrospective cohort study conducted between January 2007 and December 2015. Eighty-seven neonates who were prenatally diagnosed with CAKUT were included in the study. Cord blood CysC and creatinine levels were compared between the survivor and non-survivor groups at discharge from hospital.

Results

Of the 87 neonates enrolled in the study, 67 survived and 21 died before discharge. Median cord blood CysC levels were higher in the non-survivor group than in the survivor group (4.28 vs. 1.96 mg/L, respectively; p < 0.001). Cord blood creatinine levels were not significantly different between the two groups. In patients with oligohydramnios (n = 28), cord blood CysC levels were significantly higher in the non-survivor group than in the survivor group (4.28 vs. 2.23 mg/L, respectively; p = 0.002).

Conclusions

In this study population, cord blood CysC levels were significantly higher in the non-survivor group with CAKUT than in the survivor group. These results suggest that cord blood CysC levels may be a good marker of the severity of renal dysfunction at birth.

Ichikawa I, Kuwayama F, Pope JC, Stephens FD, Miyazaki Y (2002) Paradigm shift from classic anatomic theories to contemporary cell biological views of CAKUT. Kidney Int 61:889–898CrossRefPubMed

Klaassen I, Neuhaus TJ, Mueller-Wiefel DE, Kemper MJ (2007) Antenatal oligohydramnios of renal origin: long-term outcome. Nephrol Dial Transplant 22:432–439CrossRefPubMed

Parvex P, Combescure C, Rodriguez M, Birraux J, Girardin E (2014) Evaluation and predictive factors of renal function progression using cystatin C and creatinine in neonates born with CAKUT. Clin Nephrol 81:338–344CrossRefPubMed

Sanna-Cherchi S, Ravani P, Corbani V, Parodi S, Haupt R, Piaggio G, Innocenti ML, Somenzi D, Trivelli A, Caridi G, Izzi C, Scolari F, Mattioli G, Allegri L, Ghiggeri GM (2009) Renal outcome in patients with congenital anomalies of the kidney and urinary tract. Kidney Int 76:528–533CrossRefPubMed

Joshi S, Kotecha S (2007) Lung growth and development. Early Hum Dev 83:789–794CrossRefPubMed

Mehler K, Beck BB, Kaul I, Rahimi G, Hoppe B, Kribs A (2011) Respiratory and general outcome in neonates with renal oligohydramnios–a single-centre experience. Nephrol Dial Transplant 26:3514–3522

Wu CS, Chen CM, Chou HC (2017) Pulmonary hypoplasia induced by oligohydramnios: findings from animal models and a population-based study. Pediatr Neonatol 58:3–7

Morris RK, Malin GL, Quinlan-Jones E, Middleton LJ, Hemming K, Burke D, Daniels JP, Khan KS, Deeks J, Kilby MD (2013) Percutaneous vesicoamniotic shunting in lower urinary tract obstruction (PLUTO) collaborative group: percutaneous vesicoamniotic shunting versus conservative management for fetal lower urinary tract obstruction (PLUTO): a randomised trial. Lancet 382:1496–1506CrossRefPubMedPubMedCentral

Laudy JA, Wladimiroff JW (2000) The fetal lung 2: pulmonary hypoplasia. Ultrasound Obstet Gynecol 16:482–494CrossRefPubMed

10.

Melo BF, Aguiar MB, Bouzada MC, Aguiar RL, Pereira AK, Paixao GM, Linhares MC, Valerio FC, Simoes E, Silva AC, Oliveira EA (2012) Early risk factors for neonatal mortality in CAKUT: analysis of 524 affected newborns. Pediatr Nephrol 27:965–972CrossRefPubMed

11.

Nef S, Neuhaus TJ, Sparta G, Weitz M, Buder K, Wisser J, Gobet R, Willi U, Laube GF (2016) Outcome after prenatal diagnosis of congenital anomalies of the kidney and urinary tract. Eur J Pediatr 175:667–676CrossRefPubMed

12.

Kumar M, Thakur S, Puri A, Shukla S, Sharma S, Perumal V, Chawla R, Gupta U (2014) Fetal renal anomaly: factors that predict survival. J Pediatr Urol 10:1001–1007CrossRefPubMed

13.

Treiber M, Pecovnik Balon B, Gorenjak M (2015) A new serum cystatin C formula for estimating glomerular filtration rate in newborns. Pediatr Nephrol 30:1297–1305CrossRefPubMed

14.

Parvex P, Combescure C, Rodriguez M, Girardin E (2012) Is cystatin C a promising marker of renal function, at birth, in neonates prenatally diagnosed with congenital kidney anomalies? Nephrol Dial Transplant 27:3477–3482CrossRefPubMed

15.

Demirel G, Celik IH, Canpolat FE, Erdeve O, Biyikli Z, Dilmen U (2013) Reference values of serum cystatin C in very low-birthweight premature infants. Acta Paediatr 102:e4–e7CrossRefPubMed

16.

Filler G (2015) A step forward towards accurately assessing glomerular filtration rate in newborns. Pediatr Nephrol 30:1209–1212CrossRefPubMed

17.

Armangil D, Yurdakok M, Canpolat FE, Korkmaz A, Yigit S, Tekinalp G (2008) Determination of reference values for plasma cystatin C and comparison with creatinine in premature infants. Pediatr Nephrol 23:2081–2083CrossRefPubMed

18.

Abitbol CL, Seeherunvong W, Galarza MG, Katsoufis C, Francoeur D, DeFreitas M, Edwards-Richards A, Master Sankar Raj V, Chandar J, Duara S, Yasin S, Zilleruelo G (2014) Neonatal kidney size and function in preterm infants: what is a true estimate of glomerular filtration rate? J Pediatr 164(1026–1031):e2

19.

Phelan JP, Smith CV, Broussard P, Small M (1987) Amniotic fluid volume assessment with the four-quadrant technique at 36–42 weeks’ gestation. J Reprod Med 32:540–542PubMed

20.

Chamberlain PF, Manning FA, Morrison I, Harman CR, Lange IR (1984) Ultrasound evaluation of amniotic fluid volume. II. The relationship of increased amniotic fluid volume to perinatal outcome. Am J Obstet Gynecol 150:250–254CrossRefPubMed

21.

Askenazi SS, Perlman M (1979) Pulmonary hypoplasia: lung weight and radial alveolar count as criteria of diagnosis. Arch Dis Child 54:614–618CrossRefPubMedPubMedCentral

22.

Laudy JA, Tibboel D, Robben SG, de Krijger RR, de Ridder MA, Wladimiroff JW (2002) Prenatal prediction of pulmonary hypoplasia: clinical, biometric, and Doppler velocity correlates. Pediatrics 109:250–258CrossRefPubMed

23.

Leonidas JC, Bhan I, Beatty EC (1982) Radiographic chest contour and pulmonary air leaks in oligohydramnios-related pulmonary hypoplasia (Potter’s syndrome). Investig Radiol 17:6–10CrossRef

24.

Ishikura K, Uemura O, Ito S, Wada N, Hattori M, Ohashi Y, Hamasaki Y, Tanaka R, Nakanishi K, Kaneko T, Honda M (2013) Pre-dialysis chronic kidney disease in children: results of a nationwide survey in Japan. Nephrol Dial Transplant 28:2345–2355CrossRefPubMed

25.

Muller F, Dreux S, Audibert F, Chabaud JJ, Rousseau T, D’Herve D, Dumez Y, Ngo S, Gubler MC, Dommergues M (2004) Fetal serum β2-microglobulin and cystatin C in the prediction of post-natal renal function in bilateral hypoplasia and hyperechogenic enlarged kidneys. Prenat Diagn 24:327–332CrossRefPubMed

26.

Berry SM, Stone J, Norton ME, Johnson D, Berghella V; Society for Maternal-Fetal Medicine (2013) Fetal blood sampling. Am J Obstet Gynecol 209:170–180

27.

Aulbert W, Kemper MJ (2016) Severe antenatally diagnosed renal disorders: background, prognosis and practical approach. Pediatr Nephrol 31:563–574CrossRefPubMed

28.

Ikezumi Y, Uemura O, Nagai T, Ishikura K, Ito S, Hataya H, Fujita N, Akioka Y, Kaneko T, Iijima K, Honda M (2015) Beta-2 microglobulin-based equation for estimating glomerular filtration rates in Japanese children and adolescents. Clin Exp Nephrol 19:450–457CrossRefPubMed

29.

Revillard JP, Vincent C (1988) Structure and metabolism of beta-2-microglobulin. Contrib Nephrol 62:44–53CrossRefPubMed

30.

Spaggiari E, Stirnemann JJ, Heidet L, Dreux S, Ville Y, Oury JF, Delezoide AL, Muller F (2013) Outcome following prenatal diagnosis of severe bilateral renal hypoplasia. Prenat Diagn 33:1167–1172CrossRefPubMed

31.

Dommergues M, Muller F, Ngo S, Hohlfeld P, Oury JF, Bidat L, Mahieu-Caputo D, Sagot P, Body G, Favre R, Dumez Y (2000) Fetal serum beta2-microglobulin predicts postnatal renal function in bilateral uropathies. Kidney Int 58:312–316CrossRefPubMed

Title: Association between cord blood cystatin C levels and early mortality of neonates with congenital abnormalities of the kidney and urinary tract: a single-center, retrospective cohort study
Authors: Seiichi Tomotaki
Katsuaki Toyoshima
Tomoyuki Shimokaze
Jun Shibasaki
Hiroyuki Nagafuchi
Publication date: 01-11-2017
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 11/2017
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-017-3733-1

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Association between cord blood cystatin C levels and early mortality of neonates with congenital abnormalities of the kidney and urinary tract: a single-center, retrospective cohort study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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