Online ISSN: 2515-8260

Neonatal renal immaturity, proteinuria and glomerular filtration rate: A neglected close interknit trio

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1Dr SagunaPandit, 2Dr YashuSaini

Abstract

Objective: 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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