Serum creatinine during physiological perinatal dehydration may estimate individual nephron endowment
It is well known that the nephron endowment of healthy subjects is highly variable and that individual nephron mass has potentially important implications both in health and disease. However, nephron count is technically impossible in living subjects. Based on the observation of an increase in serum creatinine (sCr) in otherwise healthy newborns with solitary kidney during the physiological perinatal dehydration, we hypothesized that perinatal sCr might be helpful in identifying healthy subjects with a reduced nephron mass. In the framework of a study on blood pressure in babies (NeoNeph), sCr of normal Caucasian neonates was determined 48–96 h after birth and their association with a family history of arterial hypertension (AH) was analyzed. SCr was determined in 182 normal newborns (90 males) at a mean of 61 ± 8 h after birth (range 46–82). Newborns with paternal AH had a higher mean sCr (0.97 + 0.28 mg/dL) then newborns without paternal AH (0.73 + 0.28 mg/dL; p = 0.006). No differences in mean sCr were found in relation with mother or grandparent’s history of AH.
What is Known:
• Nephron endowment of healthy subjects is highly variable and individual nephron mass has potentially important implications both in health and disease however nephron count is not feasible in living subjects.
What is New:
• Serum creatinine during perinatal dehydration is a possible biomarker for identifying normal subjects with a reduced nephron mass.
KeywordsNephron endowment Newborn Arterial hypertension Blood Pressure Perinatal serum creatinine
We are very thankful to Professor Otto Mehls and Dr. Giacomo Cavallaro for their precious suggestions and comments. We are also very thankful to all the nurses of the Neonatal Unit for their essential cooperation.
Gianluigi Ardissino, MD, PhD, conceptualized and designed the study, analyzed the data, drafted the initial manuscript, and revised and approved the final version.
Francesca Tel designed the data collection instruments, performed data collection, revised the article, and approved the final version.
Michela Perrone designed the data collection instruments, performed data collection, and the editing of the manuscript.
Ilaria Possenti performed data collection, edited, revised, and approved the final version.
Mariangela Pavesi performed kidney ultrasonography and revised and approved the final version.
Giulia Forni performed laboratory assessment and revised and approved the final version.
Patrizia Salice performed data collection and revised and approved the final version.
Lorenzo Colombo performed data collection and revised and approved the final version.
Stefano Ghirardello performed data collection and revised and approved the final version.
Bianca Castiglione performed data collection.
Dario Consonni performed the statistical analysis and revised and approved the final version.
Laura Baca performed data collection and revised and approved the final version.
Daniela Li Vecchi performed data collection and revised and approved the final version.
Giancarlo la Marca performed laboratory assessment and revised and approved the final version.
Fabio Mosca contributed in conceptualizing and designing the study and revised and approved the final version.
Compliance with ethical standards
The study was approved by the Ethics Committee of our Institution.
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Appel LJ, Brands MW, Daniels SR, American Heart Association et al (2006) Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension 47(2):296–308. https://doi.org/10.1161/01.HYP.0000202568.01167.B6 CrossRefPubMedGoogle Scholar
- 2.Aronow WS, Fleg JL, Pepine CJ, Task Force et al (2011) ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Circulation 123(21):2434–2506. https://doi.org/10.1161/CIR.0b013e31821daaf6 CrossRefPubMedGoogle Scholar
- 7.Faa G, Gerosa C, Fanni D, Nemolato S, Locci A, Cabras T, Marinelli V, Puddu M, Zaffanello M, Monga G, Fanos V (2010) Marked interindividual variability in renal maturation of preterm infants: lessons from autopsy. J Matern Fetal Neonatal Med 23(S3):129–133. https://doi.org/10.3109/14767058.2010.510646 CrossRefPubMedGoogle Scholar
- 18.Neugarten J, Kasiske B, Silbiger S, Nyengaard JR (2000) Effects of gender on renal structure and the progression of chronic renal disease. J Am Soc Nephrol 11:72AGoogle Scholar