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Normal values of urine total protein- and albumin-to-creatinine ratios in term newborns

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Abstract

Background

It is important to have an accurate assessment of urinary protein when glomerulopathy or kidney injury is suspected. Currently available normal values for the neonate population have limited value, in part because they are based on small populations and obsolete creatinine assays. We have performed a prospective study with the aim to update the normal upper values of the urinary total protein-to-creatinine and albumin-to-creatinine ratios in term newborns.

Methods

Urine samples were collected from 277 healthy, full-term newborns within the first 48 hours (D0–1) and between 72 and 120 h of life (D3–4). Total protein, albumin, creatinine and osmolality were measured and the upper limit of normal (upper-limit) values determined.

Results

At D0–1 and D3–4, the upper-limit values for the total protein-to-creatinine ratio were 1431 and 1205 mg/g (162 and 136 g/mol) and those for the albumin-to-creatinine ratio were 746 and 301 mg/g (84 and 34 g/mol), respectively. The upper-limit values were significantly higher at D0–1 than at D3–4 only for the albumin-to-creatinine ratio.

Conclusion

This study determined the upper limit of normal values for urinary total protein-to-creatinine and albumin-to-creatinine ratios in the largest population of newborns studied to date. These values can therefore be considered as the most clinically relevant data currently available for the detection and diagnosis of glomerular injury in daily clinical practice in this population.

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References

  1. Hogg RJ, Portman RJ, Milliner D, Lemley KV, Eddy A, Ingelfinger J (2000) Evaluation and management of proteinuria and nephrotic syndrome in children: recommendations from a pediatric nephrology panel established at the National Kidney Foundation conference on proteinuria, albuminuria, risk, assessment, detection, and elimination (PARADE). Pediatrics 105:1242–1249

    Article  CAS  PubMed  Google Scholar 

  2. Hogg RJ, Furth S, Lemley KV, Portman R, Schwartz GJ, Coresh J, Balk E, Lau J, Levin A, Kausz AT, Eknoyan G, Levey AS (2003) National kidney foundation’s kidney disease outcomes quality initiative clinical practice guidelines for chronic kidney disease in children and adolescents: evaluation, classification, and stratification. Pediatrics 111:1416–1421

    Article  PubMed  Google Scholar 

  3. Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, Hogg RJ, Perrone RD, Lau J, Eknoyan G (2003) National kidney foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 139:137–147

    Article  PubMed  Google Scholar 

  4. Galaske RG (1986) Renal functional maturation: renal handling of proteins by mature and immature newborns. Eur J Pediatr 145:368–371

    Article  CAS  PubMed  Google Scholar 

  5. Hua MJ, Kun HY, Jie CS, Yun NZ, De WQ, Yang Z (1997) Urinary microalbumin and retinol-binding protein assay for verifying children’s nephron development and maturation. Clin Chim Acta 264:127–132

    Article  CAS  PubMed  Google Scholar 

  6. Barratt TM, McLaine PN, Soothill JF (1970) Albumin excretion as a measure of glomerular dysfunction in children. Arch Dis Child 45:496–501

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Clark PM, Bryant TN, Hall MA, Lowes JA, Rowe DJ (1989) Neonatal renal function assessment. Arch Dis Child 64:1264–1269

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Fell JM, Thakkar H, Newman DJ, Price CP (1997) Measurement of albumin and low molecular weight proteins in the urine of newborn infants using a cotton wool ball collection method. Acta Paediatr 86:518–522

    Article  CAS  PubMed  Google Scholar 

  9. Lehrnbecher T, Greissinger S, Navid F, Pfuller H, Jeschke R (1998) Albumin, IgG, retinol-binding protein, and alpha1-microglobulin excretion in childhood. Pediatr Nephrol 12:290–292

    Article  CAS  PubMed  Google Scholar 

  10. Smith GC, Winterborn MH, Taylor CM, Lawson N, Guy M (1994) Assessment of retinol-binding protein excretion in normal children. Pediatr Nephrol 8:148–150

    Article  CAS  PubMed  Google Scholar 

  11. Myers GL, Miller WG, Coresh J, Fleming J, Greenberg N, Greene T, Hostetter T, Levey AS, Panteghini M, Welch M, Eckfeldt JH (2006) Recommendations for improving serum creatinine measurement: a report from the laboratory working group of the national kidney disease education program. Clin Chem 52:5–18

    Article  CAS  PubMed  Google Scholar 

  12. Chavers BM, Rheault MN, Foley RN (2011) Kidney function reference values in US adolescents: national health and nutrition examination survey 1999-2008. Clin J Am Soc Nephrol 6:1956–1962

    Article  PubMed  PubMed Central  Google Scholar 

  13. Coulthard MG, Hey EN, Al-Dahhan J, Haycock GB (2000) Evaluating urinary flow and solute excretion from urinary creatinine in the first week of life. Arch Dis Child Fetal Neonatal Ed 82:F257–258

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Matos V, Drukker A, Guignard JP (1999) Spot urine samples for evaluating solute excretion in the first week of life. Arch Dis Child Fetal Neonatal Ed 80:F240–242

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Saint-Faust M, Boubred F, Simeoni U (2014) Renal development and neonatal adaptation. Am J Perinatol 31:773–780

    Article  CAS  PubMed  Google Scholar 

  16. Slev PR, Bunker AM, Owen WE, Roberts WL (2010) Pediatric reference intervals for random urine calcium, phosphorus and total protein. Pediatr Nephrol 25:1707–1710

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank all of the midwives and the nursing auxiliary staff for collecting the urine samples. We also thank Martine Botte, Philippe Pot, Sylvie Bourthoumieu, Anne Constanty, Elena Piguet and the CRBioLim for their technical support.

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Authors and Affiliations

  1. Collection Biologique, Hôpital de la Mère et de l’Enfant (CB-HME), CHU Limoges, Limoges, France

    Chahrazed El Hamel, Catherine Yardin & Vincent Guigonis

  2. Service de pédiatrie, Hôpital de la mère et de l’enfant, CHU Limoges, Limoges Cedex, France

    Chahrazed El Hamel, Séverine Thon & Vincent Guigonis

  3. Comité de l’hôpital de la mère et de l’enfant pour la recherche clinique (CHREC), CHU Limoges, Limoges, France

    Chahrazed El Hamel, Catherine Yardin & Vincent Guigonis

  4. Laboratoire de biochimie, CHU Limoges, Limoges, France

    Thierry Chianea

  5. Service d’obstétrique, CHU Limoges, Limoges, France

    Anne Lepichoux

  6. Laboratoire de cytogénétique, CHU Limoges, Limoges, France

    Catherine Yardin

Authors
  1. Chahrazed El Hamel
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  2. Thierry Chianea
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  3. Séverine Thon
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  4. Anne Lepichoux
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  5. Catherine Yardin
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  6. Vincent Guigonis
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Corresponding author

Correspondence to Chahrazed El Hamel.

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Funding source

This work was supported by grants from the Conseil regional, Limousin, France.

Financial disclosure

The authors have no financial relationships relevant to this article to disclose.

Conflict of interest

The authors have no potential conflicts of interest to disclose.

Ethics statement

Written informed consent was obtained from the parents for all samples before any collection was done. This study was approved by the local ethics committee (CPP SOOM 4, Limoges, France).

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El Hamel, C., Chianea, T., Thon, S. et al. Normal values of urine total protein- and albumin-to-creatinine ratios in term newborns. Pediatr Nephrol 32, 113–118 (2017). https://doi.org/10.1007/s00467-016-3427-0

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  • DOI: https://doi.org/10.1007/s00467-016-3427-0

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