Neonatal renal immaturity, proteinuria and glomerular filtration rate: A neglected close interknit trio
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 4, Pages 2348-2355
AbstractObjective: To assess the urinary total protein excretion in neonates at different gestational
ages. To calculate the Glomerular filtration rate of neonates at different gestational ages.
Methods:Cross sectional study was conducted at tertiary hospital in India. We randomly
selected 175 normal newborns of different gestational ages. Systemic random spot second
urine samples of normal newborns were selected (urine which baby had passed for first time
after birth was not used for sampling. Samples were used to estimate urinary proteins
(total)(mg/dl), urine albumin(mg/dl) and urinary creatinine(mg/dl). Urine Albumin Creatinine
ratio (mg/gm) was calculated using above variables. Similarly cord blood at birth and blood
sample at 24 hours of life were taken to estimate serum creatinine. This was used to calculate
eGFR from cord blood and blood samples at 24 hours of life respectively.
Results: Minimum and maximum eGFR was 18.3 and 37.1 ml/min/ 1.73m2, serum creatinine
values were ranging from 0.7 to 0.8 mg/dl. Spot urine total protein values were ranging
between 10-30 mg/dl. Spot urine microalbumin values ranged from 0.9 – 9.1mg/dl.
Conclusion: eGFR of newborns in our sample whose gestational age varied from 28 to 41
weeks of gestation ranged from 19.6 – 37.1 ml/1.73m2/min, this clearly shows that all
neonates behave like patients of CKD stage III / IV in terms of functional capacity of their
kidney and hence extreme care should be taken while handling their fluids, electrolytes and
acid base status and during administering nephrotoxic drugs. All newborns have proteinuria
which is primarily tubular in origin due to tubular immaturity
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