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Reference intervals of serum cystatin C/creatinine ratio of 30 postnatal days in neonates

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Abstract

Background

A number of recent reports have suggested that the cystatin C/creatinine (CysC/Cr) ratio might be a useful biomarker of renal function in pediatric patients. In this study we investigated the reference intervals of the serum CysC/Cr ratio for neonates including very low birth weight infants.

Case-Diagnosis/Treatment

A total of 883 blood samples were collected from 246 neonates during the first 30 days of life for the concurrent measurement of serum CysC and Cr levels. Infants with symptoms or signs of acute kidney injury, systemic illness, congenital anomaly, or renal pathology were excluded. The association between serum CysC/Cr ratio and the subgroups of patients was also analyzed. Reference intervals of serum CysC/Cr ratio were determined according to the postnatal age and post-conceptional age (PCA). CysC/Cr ratio level increased according to PCA, except in the first three postnatal days. The serum CysC/Cr ratio correlated positively with gestational age at birth, birth weight, postnatal age, and PCA, and negatively with serum CysC and Cr (P < 0.001).

Conclusions

Reference levels of serum CysC/Cr ratio were determined according to postnatal age and PCA. As the serum CysC/Cr ratio is dependent on several clinical parameters, these should be considered when assessing the serum CysC/Cr ratio in neonates.

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Authors and Affiliations

  1. Department of Pediatrics, School of Medicine, Kyung Hee University, Seoul, Republic of Korea

    Chong-Woo Bae

  2. Department of Pediatrics, Soon Chun Hyang University Hospital, Soonchunhyang 6-gil 31, Bongmyung-dong, Dongnam-gu, Cheonan, Choongchungnam-do, 330-721, Republic of Korea

    Won-Ho Hahn

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  1. Won-Ho Hahn
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Correspondence to Won-Ho Hahn.

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Supplementary Figure 1

Serum cystatin C/creatinine (CysC/Cr) ratio according to postconceptional age (PCA) with postnatal age day 1–3 and 4–6 (A), day 7–10 and 11–15 (B), and day 16–21 and 22–30 (C) in preterm and term infants. The diagonal solid and dashed lines represent the regression line and 95 % confidence intervals. The formula of regression lines: (A) day 1–3: serum CysC (mg/dL)/Cr (mg/dL) ratio = 2.682 − 0.002 × PCA (week); day 4–6: serum CysC/Cr ratio = −1.474 + 0.125 × PCA (B) day 7–10: serum CysC/Cr ratio = −2.067 + 0.163 × PCA; day 11–15: serum CysC/Cr ratio = −4.362 + 0.242 × PCA; (C) day 16–21: serum CysC/Cr ratio = −5.250 + 0.279 × PCA; day 22–30: serum CysC/Cr ratio = −7.621 + 0.359 × PCA. (PPT 216 kb)

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Hahn, WH., Bae, CW. Reference intervals of serum cystatin C/creatinine ratio of 30 postnatal days in neonates. Pediatr Nephrol 29, 311–314 (2014). https://doi.org/10.1007/s00467-013-2632-3

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  • DOI: https://doi.org/10.1007/s00467-013-2632-3

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