GFR estimated from cystatin C versus creatinine in children born small for gestational age

GFR estimated from cystatin C versus creatinine in children born small for gestational age

Author Franco, Maria C. P. Autor UNIFESP Google Scholar
Nishida, Sonia K. Autor UNIFESP Google Scholar
Sesso, Ricardo Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background: Low birth weight caused by intrauterine growth restriction may be a risk factor for renal impairment in the adult life.Study Design: A cross-sectional study.Setting & Participants: 71 children aged 8 to 13 years living in the community of São Paulo, Brazil, were included in the study. Gestational age was within the normal range.Predictors: Birth weight (range, 2,052 to 3,560 g) divided into quartiles: 2,500 g or less; 2,501 to 2,740 g; 2,741 to 3,000 g; and greater than 3,000 g. Birth weight ascertained by birth records in 43 and by recall in 28 participants.Outcomes & Measurements: Cystatin C, creatinine, and glomerular filtration rate (GFR) estimated by equations using cystatin C (eGFR(cys)) or creatinine (eGFR(cr)).Results: Overall, mean serum creatinine level was 0.8 +/- 0.01 (SE) mg/dL (range, 0.7 to 1.1 mg/dL); mean plasma cystatin C level was 0.9 +/- 0.02 mg/L (range, 0.5 to 1.6 mg/L), and eGFR(cr) and eGFR(cys) were 102.4 +/- 2.16 (range, 66 to 140) and 91.8 +/- 2.46 mL/min/1.73 m(2) (range, 49 to 139 mL/min/1.73 m(2)), respectively. No differences were found for serum creatinine or eGFR(cr) values among the birth-weight quartiles. There was a significant linear trend of increasing cystatin C levels (decreasing eGFR(cys) in the lower birth-weight quartile groups (P = 0.002 and P = 0.02, respectively). Systolic blood pressure correlated with plasma cystatin C level (r = 0.31; P = 0.008) and eGFR(cys) (r = -0.26; P = 0.028). Covariance analysis adjusting for age, sex, body mass index for age compared with standards of the National Center for Health Statistics and expressed as a z score, and systolic blood pressure showed that cystatin C values remained greater in the lowest than highest birth-weight quartile (1.01 +/- 0.05 versus 0.83 +/- 0.05 mg/L; P = 0.02).Limitations: Ascertainment of birth weight by recall in some participants. Lack of measurement of microalbuminuria, absence of direct GFR measurement, and small sample size.Conclusions: Lower birth weight is associated with higher levels of cystatin C but not creatinine in 8-13 yr. old children born full-term.
Keywords intrauterine growth restriction
cystatin C
glomerular filtration rate
birth weight
Language English
Date 2008-06-01
Published in American Journal of Kidney Diseases. Philadelphia: W B Saunders Co-Elsevier Inc, v. 51, n. 6, p. 925-932, 2008.
ISSN 0272-6386 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 925-932
Access rights Closed access
Type Article
Web of Science ID WOS:000256551700010

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