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European Journal of Pediatrics

, Volume 177, Issue 9, pp 1383–1388 | Cite as

Serum creatinine during physiological perinatal dehydration may estimate individual nephron endowment

  • Gianluigi Ardissino
  • Francesca Tel
  • Ilaria Possenti
  • Mariangela Pavesi
  • Michela Perrone
  • Giulia Forni
  • Patrizia Salice
  • Lorenzo Colombo
  • Stefano Ghirardello
  • Bianca Castiglione
  • Dario Consonni
  • Laura Baca
  • Daniela Li Vecchi
  • Giancarlo la Marca
  • Fabio Mosca
Short Communication

Abstract

It is well known that the nephron endowment of healthy subjects is highly variable and that individual nephron mass has potentially important implications both in health and disease. However, nephron count is technically impossible in living subjects. Based on the observation of an increase in serum creatinine (sCr) in otherwise healthy newborns with solitary kidney during the physiological perinatal dehydration, we hypothesized that perinatal sCr might be helpful in identifying healthy subjects with a reduced nephron mass. In the framework of a study on blood pressure in babies (NeoNeph), sCr of normal Caucasian neonates was determined 48–96 h after birth and their association with a family history of arterial hypertension (AH) was analyzed. SCr was determined in 182 normal newborns (90 males) at a mean of 61 ± 8 h after birth (range 46–82). Newborns with paternal AH had a higher mean sCr (0.97 + 0.28 mg/dL) then newborns without paternal AH (0.73 + 0.28 mg/dL; p = 0.006). No differences in mean sCr were found in relation with mother or grandparent’s history of AH.

Conclusion: The association between parental AH and high sCr during perinatal dehydration supports the hypothesis that the latter is a promising tool for identifying normal subjects with a reduced nephron mass with potential important implications in prevention and in understanding the individual outcome of renal and extrarenal diseases (including AH).

What is Known:

Nephron endowment of healthy subjects is highly variable and individual nephron mass has potentially important implications both in health and disease however nephron count is not feasible in living subjects.

What is New:

Serum creatinine during perinatal dehydration is a possible biomarker for identifying normal subjects with a reduced nephron mass.

Keywords

Nephron endowment Newborn Arterial hypertension Blood Pressure Perinatal serum creatinine 

Notes

Acknowledgments

We are very thankful to Professor Otto Mehls and Dr. Giacomo Cavallaro for their precious suggestions and comments. We are also very thankful to all the nurses of the Neonatal Unit for their essential cooperation.

Authors’ contributions

Gianluigi Ardissino, MD, PhD, conceptualized and designed the study, analyzed the data, drafted the initial manuscript, and revised and approved the final version.

Francesca Tel designed the data collection instruments, performed data collection, revised the article, and approved the final version.

Michela Perrone designed the data collection instruments, performed data collection, and the editing of the manuscript.

Ilaria Possenti performed data collection, edited, revised, and approved the final version.

Mariangela Pavesi performed kidney ultrasonography and revised and approved the final version.

Giulia Forni performed laboratory assessment and revised and approved the final version.

Patrizia Salice performed data collection and revised and approved the final version.

Lorenzo Colombo performed data collection and revised and approved the final version.

Stefano Ghirardello performed data collection and revised and approved the final version.

Bianca Castiglione performed data collection.

Dario Consonni performed the statistical analysis and revised and approved the final version.

Laura Baca performed data collection and revised and approved the final version.

Daniela Li Vecchi performed data collection and revised and approved the final version.

Giancarlo la Marca performed laboratory assessment and revised and approved the final version.

Fabio Mosca contributed in conceptualizing and designing the study and revised and approved the final version.

Compliance with ethical standards

The study was approved by the Ethics Committee of our Institution.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Gianluigi Ardissino
    • 1
  • Francesca Tel
    • 1
  • Ilaria Possenti
    • 1
  • Mariangela Pavesi
    • 2
  • Michela Perrone
    • 3
  • Giulia Forni
    • 4
  • Patrizia Salice
    • 5
  • Lorenzo Colombo
    • 3
  • Stefano Ghirardello
    • 3
  • Bianca Castiglione
    • 3
  • Dario Consonni
    • 6
  • Laura Baca
    • 5
  • Daniela Li Vecchi
    • 5
  • Giancarlo la Marca
    • 4
  • Fabio Mosca
    • 3
  1. 1.Pediatric Nephrology, Dialysis and Transplantation Unit – Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
  2. 2.Department of Radiology – Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
  3. 3.Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore PoliclinicoUniversity of MilanMilanItaly
  4. 4.Department of Neurosciences, Psychology, Pharmacology and Child HealthUniversity of FlorenceFlorenceItaly
  5. 5.Pediatric Cardiology Unit – Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
  6. 6.Epidemiology Unit – Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly

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