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Evaluation and predictive factors of renal function progression using cystatin C and creatinine in neonates born with

Paloma Parvex, Chistophe Combescure, Maria Rodriguez

    Clinical Nephrology
    |April 3, 2014
    PubMed

    Insights

    Cystatin C (CysC) is a better marker than creatinine for monitoring kidney function in neonates with congenital anomalies of the kidney and urinary tract (CAKUT). Bilateralism and asymmetric relative renal function are linked to disease progression.

    Area of Science:

    • Pediatric Nephrology
    • Biomarker Discovery
    • Renal Function Assessment

    Background:

    • Congenital anomalies of the kidney and urinary tract (CAKUT) affect 1 in 500 pregnancies and are a leading cause of childhood end-stage renal disease.
    • Currently, no validated early predictive markers exist for long-term renal function (RF) in neonates with CAKUT.

    Purpose of the Study:

    • To compare Cystatin C (CysC) and creatinine (creat) as markers of RF from birth to 2 years in neonates with CAKUT.
    • To identify factors associated with RF progression in this population.

    Main Methods:

    • A cohort of 56 neonates with CAKUT was followed for a median of 235 days.
    • Repeated measures of CysC and creat were taken over 2 years to analyze changes in RF with age.
    • Potential risk factors including kidney disease type, bilateralism, prenatal pelvic dilatation, reflux, and initial relative RF asymmetry were assessed.

    Main Results:

    • Both CysC and creatinine showed a rapid decrease in the first month, followed by stabilization after one year.
    • CysC demonstrated a significant decrease between 1 month and 1 year, while creatinine stabilized.
    • Multivariate analysis revealed that CysC levels were significantly associated with bilateralism and asymmetric relative RF, whereas creatinine was not.

    Conclusions:

    • Cystatin C is a more effective biomarker than creatinine for monitoring renal function in neonates with CAKUT.
    • Bilateralism and asymmetric relative renal function are significant predictors of RF progression in neonates with CAKUT, as identified by CysC.
    Abstract

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