Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.
Clinical Chemistry Laboratory, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.
Nutrients. 2020 Feb 28;12(3):651. doi: 10.3390/nu12030651.
Background: Kidney function in preterm newborns may be impaired by many factors.
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 (3 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.
Newborns with GA ≤ 28 weeks had higher sCr at T0, and lower sCr, BTP and higher urea levels at T36 ( = 0.007, = 0.005 and = 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.
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.
早产儿的肾功能可能会受到多种因素的影响。
共纳入 71 名胎龄（GA）<32 周的新生儿。在 T0（生后 3 天）和 T36（GA 36 周）时检测血清肌酐（sCr）、胱抑素 C（CysC）、β-痕迹蛋白（BTP）和尿素，根据不同公式在 T36 时计算估计肾小球滤过率（eGFR）。计算产前和产后肾脏损伤风险评分。
GA≤28 周的新生儿 T0 时 sCr 较高，T36 时 sCr、BTP 较低，尿素水平较高（=0.007、=0.005 和=0.029）。仅使用 CysC 计算时，根据公式 eGFR 值与 GA 无关，但根据其他公式，GA≤28 周的受试者 eGFR 值较高。基于 sCr 的公式计算的产后评分与 eGFR 呈正相关，但在调整尿素水平和 GA 后，相关性不再持续。
基于 CysC 的 eGFR 值不受 GA 影响。基于 sCr 的公式计算的产后评分与 eGFR 呈直接相关，在调整 GA 和尿素水平后不再持续，这表明营养状况的重要性，因为更多的早产儿接受更积极的营养治疗，尿素水平更高证明了这一点。
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