Preterm Small Gestational Age Newborns: Impact on Renal Size and Function

Marwa El-Sharkawy; Magda Badawy; Soha M. Abd El Dayem; Ahmed Badr; Hassan Salama; Inji Galal El-Dine  Abdou El-Sherbini; Sherif  Abd El-Momeim

doi:10.3889/oamjms.2020.5005

Authors

Marwa El-Sharkawy Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
Magda Badawy Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
Soha M. Abd El Dayem Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Ahmed Badr Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
Hassan Salama Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Inji Galal El-Dine Abdou El-Sherbini Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Sherif Abd El-Momeim Pediatrics Department, National Research Centre, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2020.5005

Keywords:

PT/SGA, renal size and function, Cystatin C, eGFR

Abstract

OBJECTIVE: The objective of the study was to evaluate the size and function of the kidney in high-risk premature small gestational age (PT/SGA) newborns. Furthermore, estimation of the glomerular filtration rate (GFR) was done by comparing Cystatin C-based method with the creatinine –based method in those preterm newborns.

PATIENTS AND METHODS: The study included 20 PT/SGA and controls (20 preterm appropriate for gestational age [PT/AGA] and 20 full-term [FT] newborns). Serum creatinine, blood urea nitrogen, and cystatin C were determined on days 3 and 7 of the study for all newborn infants. GFR was assessed by cystatin C-based method and creatinine-based method. Evaluation of the renal size by ultrasound was done on day 7 of neonatal life.

RESULTS: A significant difference was found in the length and transverse diameter of both kidneys, comparing PT/SGA group with PT/AGA and FT group. Cystatin C on day 3 of PT/SGA group had a significant difference than PT/AGA and FT group. Estimation of GFR (eGFR) calculated by filler Zappitelli, Grubb, Larsson, and Dorum formulae of PT/SGA group had a significant difference comparing with PT/AGA and FT group on days 3 and 7.

CONCLUSION: PT/SGA newborns have reduced renal size and immature renal function. Cystatin C is a marker for renal function superior to creatinine as it is not affected by body mass index, gestational age, and birth weight. Cystatin C-based eGFR is more accurate and more sensitive to minor changes in GFR than creatinine-based equation.

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