Urinary Cystatin-C, a marker to assess and monitor neonatal kidney maturation and function: validation in twins

Urinary Cystatin-C, a marker to assess and monitor neonatal kidney maturation and function: validation in twins

BACKGROUND: Nephrogenesis is a complex process of nephron formation and maturation that can be compromised by preterm delivery and intrauterine growth restriction. This study aimed to evaluate and compare urinary Cys-C levels with renai volume in a cohort of preterm and term twins, adequate for gestational age or intrauterine growth restricted, to investigate their values in different conditions of nephrogenesis.
METHODS: The study was performed on twins at 30-40 days of postnatal corrected age: renai volumes were measured by 3D ultrasound technology and urine samples were analyzed for Cystatin-C. A follow-up was performed by Cystatin-C.
RESULTS: Renai volumes in preterm and intrauterine growth-restricted twins showed values significantly lower than those observed in term twins and were inversely correlateci to urinary Cystatin-C levels. During the follow-up, intrauterine growth­restricted twins showed amplified levels of urinary Cystatin-C; in contrast, invariable or decreased levels were observed in adequate for gestational age twins.
CONCLUSIONS: Urinary Cystatin-C, evaluated when intrauterine/extrauterine nephrogenesis could be considered compieteci, concurrently with renai volume assessment can improve the identification of neonates with initial kidney impairment. lts potential value as a useful marker in monitoring physiological/pathological renai conditions could be considered, mainly for neonates at elevateci risk of developing long-term renai diseases.