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Serum creatinine during physiological perinatal dehydration may estimate individual nephron endowment

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Abstract

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.

Conclusion: The association between parental AH and high sCr during perinatal dehydration supports the hypothesis that the latter is a promising tool for identifying normal subjects with a reduced nephron mass with potential important implications in prevention and in understanding the individual outcome of renal and extrarenal diseases (including 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.

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Acknowledgments

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.

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Authors and Affiliations

  1. Pediatric Nephrology, Dialysis and Transplantation Unit – Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, via Commenda 9, 20122, Milan, Italy

    Gianluigi Ardissino, Francesca Tel & Ilaria Possenti

  2. Department of Radiology – Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, via Commenda 9, 20122, Milan, Italy

    Mariangela Pavesi

  3. Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milan, Italy

    Michela Perrone, Lorenzo Colombo, Stefano Ghirardello, Bianca Castiglione & Fabio Mosca

  4. Department of Neurosciences, Psychology, Pharmacology and Child Health, University of Florence, viale Pieraccini 6, 50139, Florence, Italy

    Giulia Forni & Giancarlo la Marca

  5. Pediatric Cardiology Unit – Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122, Milan, Italy

    Patrizia Salice, Laura Baca & Daniela Li Vecchi

  6. Epidemiology Unit – Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, via Comenda 12, 20122, Milan, Italy

    Dario Consonni

Authors
  1. Gianluigi Ardissino
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  2. Francesca Tel
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  3. Ilaria Possenti
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  9. Stefano Ghirardello
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  10. Bianca Castiglione
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  14. Giancarlo la Marca
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  15. Fabio Mosca
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Contributions

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.

Corresponding author

Correspondence to Gianluigi Ardissino.

Ethics declarations

The study was approved by the Ethics Committee of our Institution.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Communicated by Patrick Van Reempts

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Ardissino, G., Tel, F., Possenti, I. et al. Serum creatinine during physiological perinatal dehydration may estimate individual nephron endowment. Eur J Pediatr 177, 1383–1388 (2018). https://doi.org/10.1007/s00431-018-3087-0

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  • DOI: https://doi.org/10.1007/s00431-018-3087-0

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