Serum cystatin C levels in preterm newborns in our setting: Correlation with serum creatinine and preterm pathologies

Nefrologia. 2015;35(3):296-303. doi: 10.1016/j.nefro.2015.05.004. Epub 2015 Jun 19.
[Article in English, Spanish]

Abstract

Background: Cystatin C (CysC) is a renal function marker that is not as influenced as creatinine (Cr) by endogenous or exogenous agents, so it is therefore proposed as a marker in preterm infants.

Objectives: To determine serum CysC values in preterm infants during the first week of life, compared to Cr. To analyze alterations caused by prematurity diseases.

Method: The design involved a longitudinal, observational study of prospective cohorts. Groups were based on gestational age (GA): Group A (24-27 weeks), Group B (28-33 weeks), Group C (34-36 weeks). Blood samples were collected at birth, within 48-72hours and after 7 days of life.

Statistics: SPSS v.20 software was used. The statistical methods applied included chi-squared test and ANOVA.

Results: A total of 109 preterm infants were included in the study. CysC levels were: 1.54mg/L (±0.28) at birth; 1.38mg/L (±0.36) within 48-72hours of life; 1.50mg/L (±0.31) after 7 days (p<0.05). Cr levels were: 0.64mg/dL (±0.17) at birth; 0.64mg/dL (±0.28) within 48-72hours; 0.56mg/dL (±0.19) after 7 days (P<.05). CysC values were lower in hypotensive patients and those with a respiratory disease (P<.05), and no alterations associated with other diseases were observed. There were no differences in Cr levels associated with any disease. Creatinine levels were higher in patients ≤1.500g (P<.05).

Conclusions: Serum CysC decreased within 48-72hours of life, and this decline showed significance (P<.05). The levels increased after 7 days in all 3 GA groups, and there was no difference in CysC levels among the groups. More studies in preterm infants with hypotension and respiratory disease are required. CysC is a better glomerular filtration (GF) marker in ≤1.500g preterm infants.

Keywords: Cistatina C; Creatinina; Creatinine; Cystatin C; Premature infant; Pretérmino.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Biomarkers / blood
  • Body Weight
  • Creatinine / blood*
  • Cystatin C / blood*
  • Female
  • Gestational Age
  • Glomerular Filtration Rate
  • Humans
  • Hypotension / blood
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / blood*
  • Kidney Diseases / blood*
  • Kidney Diseases / congenital
  • Male
  • Prospective Studies
  • Respiration Disorders / blood
  • Time Factors

Substances

  • Biomarkers
  • CST3 protein, human
  • Cystatin C
  • Creatinine