Neonatal Kidney Size and Function in Preterm Infants: What Is a True Estimate of Glomerular Filtration Rate?

Abitbol, Carolyn; Seeherunvong, Wacharee; Galarza, Marta G.; Katsoufis, Chryso; Francoeur, Diane; DeFreitas, Marissa; Edwards-Richards, Alcia; Raj, Vimal Master Sankar; Chandar, Jayanthi; Duara, Shahnaz; Yasin, Salih; Zilleruelo, Gastón

doi:10.1016/j.jpeds.2014.01.044

Cited by 103 publications

(77 citation statements)

References 34 publications

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“…Table 2 shows the fold change of these biomarkers based on the values in day -1 compared to the control group. Preterm infants with lower birth weight may possibly have higher baseline values of some urinary AKI biomarkers (12). Therefore, we incorporated birth weight into predictive models to control for this potential confounder.…”

Section: Biomarkers As Early Predictors Of Akimentioning

confidence: 99%

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Early urinary biomarkers of acute kidney injury in preterm infants

et al. 2016

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Background: Acute kidney injury (AKI) in the neonatal intensive care setting is multifactorial and is associated with significant morbidity and mortality. This study evaluates the utility of novel urinary biomarkers to predict the development and/or severity AKI in preterm infants. Methods: We performed a case-control study on a prospective cohort of preterm infants (<32 wk), to compare seven urine biomarkers between 25 infants with AKI and 20 infants without AKI. results: Infants with AKI had significantly higher neutrophil gelatinase-associated lipocalin (NGAL) (median, control (CTRL) vs. AKI; 0.598 vs. 4.24 µg/ml; P < 0.0001). In contrast, urinary epidermal growth factor (EGF) levels were significantly lower in infants who developed AKI compared to controls (median, CTRL vs. AKI; 0.016 vs. 0.006 µg/ml; P < 0.001). The area under the curve (AUC) for NGAL for prediction of stage I AKI on the day prior to AKI diagnosis (day-1) was 0.91, and for the prediction of stage II/III, AKI was 0.92. Similarly, urine EGF was a predictor of renal injury on day -1 (AUC: 0.97 for stage I and 0.86 for stage II/III AKI). conclusion: Urinary biomarkers may be useful to predict AKI development prior to changes in serum creatinine (SCr) in preterm infants.

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Section: Biomarkers As Early Predictors Of Akimentioning

confidence: 99%

“…Abitbol et al (12) showed that serum cystatin C level is a superior biomarker to serum Cr in the assessment of GFR in a cross-sectional observational cohort of premature infants. The urine represents a rich, noninvasive source of potential biomarkers.…”

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confidence: 99%

Early urinary biomarkers of acute kidney injury in preterm infants

et al. 2016

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“…Despite its limitations, Milena Treiber's important study [26] adds new knowledge and builds on Carolyn Abitbol's landmark study [31]. This study also revives the debate on whether GFR should be normalized to either height or BSA or to extracellular volume.…”

Section: Resultsmentioning

confidence: 90%

“…This research team found renal length to correlate with GA, and term babies had a significantly better eGFR than preterm babies. The results of Abitbol et al's study suggest that CysC is superior to Cr as a marker of GFR in neonates [31]. In contrast, a Swedish study examining 61 newborn infants of a similar post-conceptual age found neither CysC nor Cr to correlate with gentamycin clearance [33].…”

Section: Introductionmentioning

confidence: 93%

“…Still, the number of published studies on the use of kidney volume as a marker of kidney function in neonates remains limited [28,29], and it may in fact be more accurate to use renal parenchymal thickness instead [30]. Carolyn Abitbol and co-workers recently measured total kidney volume in relation to serum Cr and CysC levels and a validated formula (through either inulin, iohexol or iothalamate studies) in 60 preterm and 40 term infants to calculate eGFR and GA [31]. Total kidney volume was estimated using the ellipsoid formula: volume = length × width × depth × 0.523 [32].…”

Section: Introductionmentioning

confidence: 99%

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A step forward towards accurately assessing glomerular filtration rate in newborns

Filler

2015

Pediatr Nephrol

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In this edition of Pediatric Nephrology, Milena Treiber and colleagues have published a study on cystatin C (CysC) concentrations in relation to renal volumetry in 50 small-for-gestational age (SGA) and 50 appropriate-for-gestational age (AGA) neonates, deriving a new formula for estimating neonatal glomerular filtration rate (GFR). The study builds on previous work which established that renal volumetry together with CysC blood levels is a superior method for establishing GFR in term and pre-term newborns [The Journal of Pediatrics (2014) 164:1026-1031.e2]. Treiber et al. use the expected difference between SGA and AGA renal volumes to document the superiority of their new formula, which is based on total renal volume, CysC and body surface area, but does not incorporate gold-standard inulin clearance. Treiber et al.'s study adds new knowledge to the field that will hopefully improve the safety of renally excreted critical dose drugs in the newborn period. This editorial discusses the strengths and limitations of the current study.

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Pediatric Renal Ontogeny and Applications in Drug Development

Zhang

Mehta

Muhari-Stark

et al. 2019

The Journal of Clinical Pharma

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The clinical applications of renal ontogeny mainly include renal function evaluation and optimal dosing of renally eliminated drugs in pediatric patients, which rely on pharmacometric models and/or bedside estimated glomerular filtration rate equations. However, these applications in drug development are based on an understanding of renal function development, especially when considering premature infants, and the renal biomarkers that can be used for renal function assessment. This review provides a general overview on (1) renal function development, (2) the biomarkers that are used to assess renal function, and (3) the practical application of this knowledge to drug dosing for renally eliminated drugs during pediatric development. While pharmacometric approaches for estimating renal function during development have improved considerably, the number of drug development programs that have studied premature infants is small and suggests that caution should be taken in estimating doses for renally eliminated drugs during periods of rapid change in renal function.

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Neonatal Kidney Size and Function in Preterm Infants: What Is a True Estimate of Glomerular Filtration Rate?

Cited by 103 publications

References 34 publications

Early urinary biomarkers of acute kidney injury in preterm infants

Early urinary biomarkers of acute kidney injury in preterm infants

A step forward towards accurately assessing glomerular filtration rate in newborns

Pediatric Renal Ontogeny and Applications in Drug Development

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