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Association between cord blood cystatin C levels and early mortality of neonates with congenital abnormalities of the kidney and urinary tract: a single-center, retrospective cohort study

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Abstract

Background

Some fetuses with congenital abnormalities of the kidney and urinary tract (CAKUT) have severe renal dysfunction during the prenatal period that can result in oligohydramnios, pulmonary hypoplasia, and death following birth. We hypothesized that cord blood cystatin C (CysC) levels are elevated in neonates who have life-threatening pulmonary hypoplasia and oligohydramnios due to severe renal dysfunction. In this study we compared cord blood CysC levels between a non-survivor group with CAKUT and a survivor group.

Methods

This was a single-center, retrospective cohort study conducted between January 2007 and December 2015. Eighty-seven neonates who were prenatally diagnosed with CAKUT were included in the study. Cord blood CysC and creatinine levels were compared between the survivor and non-survivor groups at discharge from hospital.

Results

Of the 87 neonates enrolled in the study, 67 survived and 21 died before discharge. Median cord blood CysC levels were higher in the non-survivor group than in the survivor group (4.28 vs. 1.96 mg/L, respectively; p < 0.001). Cord blood creatinine levels were not significantly different between the two groups. In patients with oligohydramnios (n = 28), cord blood CysC levels were significantly higher in the non-survivor group than in the survivor group (4.28 vs. 2.23 mg/L, respectively; p = 0.002).

Conclusions

In this study population, cord blood CysC levels were significantly higher in the non-survivor group with CAKUT than in the survivor group. These results suggest that cord blood CysC levels may be a good marker of the severity of renal dysfunction at birth.

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Authors and Affiliations

  1. Department of Neonatology, Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa Prefecture, 232–8555, Japan

    Seiichi Tomotaki, Katsuaki Toyoshima, Tomoyuki Shimokaze & Jun Shibasaki

  2. Department of Critical Care Medicine, Kanagawa Children’s Medical Center, Yokohama, Japan

    Hiroyuki Nagafuchi

Authors
  1. Seiichi Tomotaki
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  2. Katsuaki Toyoshima
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  3. Tomoyuki Shimokaze
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  4. Jun Shibasaki
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  5. Hiroyuki Nagafuchi
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Corresponding author

Correspondence to Seiichi Tomotaki.

Ethics declarations

The study protocol was approved by the Institutional Review Board (No. 1605–06; July 21, 2016).

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The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by any of the authors.

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Tomotaki, S., Toyoshima, K., Shimokaze, T. et al. Association between cord blood cystatin C levels and early mortality of neonates with congenital abnormalities of the kidney and urinary tract: a single-center, retrospective cohort study. Pediatr Nephrol 32, 2089–2095 (2017). https://doi.org/10.1007/s00467-017-3733-1

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  • DOI: https://doi.org/10.1007/s00467-017-3733-1

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