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Kidney Week

Abstract: TH-PO754

Serum Creatinine, Cystatin C, and a Comparison of Estimated Glomerular Filtration Rates in Very Low Birth Weight Children at 6 Years Old

Session Information

  • Pediatric CKD
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Author

  • Oka, Masafumi, Saga university, Saga, Saga, Japan
Background

According to the developmental organs of health and disease (DOHaD) theory, low birth weight is a risk factor for chronic kidney disease (CKD) in adulthood. However, there has been insufficient research into the renal function in school-aged children. In our research, we aimed to investigate the renal function of very low birth weight (VLBW), defined as less than 1,500g, children at six-year old and reveal risk factors of CKD.

Methods

We investigated 380 six-year old children who underwent a preschool physical examination, and had been among 504 VLBW infants discharged from the NICU in 1999-2011. The serum creatinine (Cr) and cystatin C (CysC) were measured, and for the >95 percentile group, a logistic regression analysis was used to study the relationships between the factors of gender, gestational age (GA), weight, height and head circumference at birth, and weight, height and BMI at the time of the physical examination. Additionally, the estimated glomerular filtration rate (eGFR) at the examination was calculated with the equation of Japanese child (JPN), Schwartz and chronic kidney disease epidemiology collaboration (CKD-EPI) and compared.

Results

Data for 337 subjects was recorded (age: 5.4±0.5 years, male:female ration = 167:170, GA: 28.3±2.7weeks, birth weight: 995±301g). Serum Cr was 0.34±0.07mg/dL and CysC was 0.77±0.13mg/L. In the >97.5 percentile group for Cr there were 7 subjects (2.1%), while for CysC, it was 13 subjects (6.4%). In the logistic regression analysis, the independent risk factors for high Cr values were GA (OR:2.25, 95%CI:1.06-4.80) and birth weight (OR:0.41, 95%CI:0.22-0.77). In the eGFR comparisons, the values were as follows: JPN (Cr:113.0±18.8 ml/min/1.73m2, CysC:130.6±19.9 ml/min/1.73m2), Schwartz(Cr:137.6±23.4 ml/min/1.73m2, CysC:92.1±12.4 ml/min/1.73m2), and CKD-EPI(Cr:191.1±19.5 ml/min/1.73m2, CysC:125.6±15.1 ml/min/1.73m2).

Conclusion

In this study of VLBW, there was a high frequency of high CysC values, and GA and birth height were identified as perinatal factors related to high Cr values. When CKD-EPI (Cr) was used in Japanese child, the values were higher than with other predictive equations.