Guido Filler1, Ricardo Guerrero-Kanan, Ana Catalina Alvarez-Elías. 1. aDepartment of Pediatrics bDepartment of Pathology and Laboratory Medicine cDepartment of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada dUniversidad Nacional Autónoma de México eDepartment of Neonatology, Hospital Angeles de Interlomas fLaboratorio de Investigacion en Nefrologia, Hospital Infantil de México Federico Gómez, México City, México.
Abstract
PURPOSE OF REVIEW: This article answers the question of whether creatinine is the best biomarker for monitoring neonatal glomerular filtration rate (GFR) in view of recent advances in measuring neonatal renal function. RECENT FINDINGS: We rely largely on serum creatinine for the estimation of GFR in the newborn, even though creatinine is freely exchanged through the placenta. During the first few days of life, the serum creatinine reflects maternal renal function or the maternal creatinine. Back filtration of creatinine in preterm newborns is also a serious limitation. This review summarizes current knowledge on the prenatal and postnatal handling of creatinine as well as that of other, more novel biomarkers of GFR, such as cystatin C (CysC) and β-trace protein (BTP). Only small amounts of CysC cross the placenta, whereas BTP does not cross the placenta at all. However, BTP measurements are not widely available. Recent studies on renal volumetry are also discussed. SUMMARY: Currently, CysC may be the most suitable marker of neonatal renal function, but its availability is still limited, it is more costly, and the best method of reporting acute kidney injury and neonatal estimated GFR remains to be established.
PURPOSE OF REVIEW: This article answers the question of whether creatinine is the best biomarker for monitoring neonatal glomerular filtration rate (GFR) in view of recent advances in measuring neonatal renal function. RECENT FINDINGS: We rely largely on serum creatinine for the estimation of GFR in the newborn, even though creatinine is freely exchanged through the placenta. During the first few days of life, the serum creatinine reflects maternal renal function or the maternal creatinine. Back filtration of creatinine in preterm newborns is also a serious limitation. This review summarizes current knowledge on the prenatal and postnatal handling of creatinine as well as that of other, more novel biomarkers of GFR, such as cystatin C (CysC) and β-trace protein (BTP). Only small amounts of CysC cross the placenta, whereas BTP does not cross the placenta at all. However, BTP measurements are not widely available. Recent studies on renal volumetry are also discussed. SUMMARY: Currently, CysC may be the most suitable marker of neonatal renal function, but its availability is still limited, it is more costly, and the best method of reporting acute kidney injury and neonatal estimated GFR remains to be established.
Authors: Phillip S Adams; Diana Vargas; Tracy Baust; Lucas Saenz; Wonshill Koh; Brian Blasiole; Patrick M Callahan; Aparna S Phadke; Khoa N Nguyen; Yuliya Domnina; Mahesh Sharma; John A Kellum; Joan Sanchez-de-Toledo Journal: Pediatr Crit Care Med Date: 2019-01 Impact factor: 3.624
Authors: Ana Flávia Lima Ruas; Gabriel Malheiros Lébeis; Nicholas Bianco de Castro; Vitória Andrade Palmeira; Larissa Braga Costa; Katharina Lanza; Ana Cristina Simões E Silva Journal: Pediatr Nephrol Date: 2021-11-30 Impact factor: 3.651
Authors: Nicola Schieda; Jason I Blaichman; Andreu F Costa; Rafael Glikstein; Casey Hurrell; Matthew James; Pejman Jabehdar Maralani; Wael Shabana; An Tang; Anne Tsampalieros; Christian B van der Pol; Swapnil Hiremath Journal: Can J Kidney Health Dis Date: 2018-06-12
Authors: Natalie Ebert; Camilla Koep; Kristin Schwarz; Peter Martus; Nina Mielke; Jan Bartel; Martin Kuhlmann; Jens Gaedeke; Markus Toelle; Markus van der Giet; Mirjam Schuchardt; Elke Schaeffner Journal: Sci Rep Date: 2017-10-04 Impact factor: 4.379