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Abstract: TH-PO499

Urinary Biomarkers in Neonates Born to Mothers with Preeclampsia

Session Information

  • Pediatric Nephrology - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Master Sankar Raj, Vimal, University of Illinois Chicago College of Medicine at Peoria, Peoria, Illinois, United States
  • Kumar, Praveen, University of Illinois Chicago College of Medicine at Peoria, Peoria, Illinois, United States
  • Warnecke, Diana Lee, University of Illinois Chicago College of Medicine at Peoria, Peoria, Illinois, United States
Background

Effects of preeclampsia on renal development or function in newborns are unknown. We hypothesized that the circulating factors causing endothelial dysfunction and impaired renal function in mothers with preeclampsia may adversely affect fetal kidneys.

Methods

All newborns with gestational age ≥32 weeks were eligible. Moms with known renal abnormalities on function or structure on prenatal ultrasound, nephrotoxic medication exposure as well as babies born with low APGAR scores, fetal distress were excluded. Bag urine samples were stored at -70° C and assayed using commercially available ELISA kits for Cystatin C,Nephrin, KIM – 1 and Klotho. Urinary creatinine and protein contents were measured using standard techniques. Comparisons between the groups were made using t-tests or Wilcoxon Rank Sum Test. For categorical variables, Chi-square or Fisher’s exact analyses were used.

Results

The baseline characteristics of 68 mothers and their newborns were comparable to each other. Urine protein and creatinine were significantly higher (Table1) while Klotho levels were significantly lower in study group. Urinary Nephrin was higher in study infants but the difference was not statistically significant (p value 0.053). There was no correlation between maternal urinary protein/creatinine ratio and levels of urinary biomarkers in their infants.

Conclusion

This cross-sectional study on urinary biomarkers among infants born to preeclampsia mothers has shown high urinary protein in the study group over control. Urinary klotho levels were also significantly lower in the study infants mirroring the existing knowledge of low klotho levels with acute renal injury and advanced CKD. Levels of urinary nephrin urinary KIM-1 and cystatin C level were not statistically different between the two groups. Further prospective studies tracking renal function, proteinuria and blood pressure measurement can provide clues to the significance of these urinary biomarkers as early screening tools for CKD in infants born to mothers with preeclampsia.

Urinary biomarkers
BiomarkerMother Preeclampsia + (%) N = 34Mother Preeclampsia - (%) N =34P value
Total Protein (mg/dl) Median (IQR)37.1 (14.4 to 53.5)20.3 (7.5 to 30.0)0.04
Creatinine (mg/dl) Median (IQR)63.4 (25.2 to 96.6)24.8 (19.8 to 44.2)0.008
Cystatin C (ng/ml) Median (IQR)2.4 (1.2 to 6.2)7.59 (1.1 to 33.8)0.12
KIM-1 (ng/ml) Median (IQR)0.035 (0.0045 to 0.20)0.074 (0.0045 to 0.30)0.16
Nephrin (µg/ml) Median (IQR)0.56 (0.06 to 1.90)0.15 (0.066 to 0.53)0.053
Klotho (pg/ml)
Median (IQR)
3.08
(3.08 to 21.28)
17.03
(3.08 to 92.36)
0.0032