title: Small renal size in newborns with spina bifida: possible causes.
abstract: BACKGROUND
  Previous studies reported that children with neural tube defects, but without any history of intrinsic renal diseases, have small kidneys when compared with age-matched standard renal growth. The aim of this study was to investigate the possible causes of small renal size in children with spina bifida by comparing growth hormone deficiency, physical limitations and hyperhomocysteinemia.
  
  
  METHODS
  The sample included 187 newborns with spina bifida. Renal sizes in the patients were assessed by using maximum measurement of renal length and the measurements were compared by using the Sutherland monogram. According to the results, the sample was divided into two groups--a group of 120 patients with small kidneys (under the third percentile) and a control group of 67 newborns with normal kidney size. Plasma total homocysteine was investigated in mothers and in their children. Serum insulin-like growth factor-1 (IGF-1) levels were measured.
  
  
  RESULTS
  Serum IGF-1 levels were normal in both groups. Children and mothers with homocysteine levels >10 μmol/l were more than twice as likely to have small kidneys and to give to birth children with small kidneys, respectively, compared with newborns and mothers with homocysteine levels <10 μmol/l. An inverse correlation was also found between the homocysteine levels of mothers and kidney sizes of children (r = - 0.6109 P ≤ 0.01).
  
  
  CONCLUSIONS
  It is highly important for mothers with hyperhomocysteinemia to be educated about benefits of folate supplementation in order to reduce the risk of small renal size and lower renal function in children.
authors.affiliation: Department of Paediatrics, Second University of Naples, Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Montaldo
authors.forename: Luisa
authors.initials: L
authors.lastname: Montaldo
authors.forename: Azzurra Concetta
authors.initials: AC
authors.lastname: Iossa
authors.forename: Marina
authors.initials: M
authors.lastname: Cennamo
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Caredda
authors.forename: Roberto
authors.initials: R
authors.lastname: Del Gado
mesh_terms: D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D005919:Glomerular Filtration Rate; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D007231:Infant, Newborn; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007668:Kidney / Q000000981:diagnostic imaging* / Q000254:growth & development; D009929:Organ Size; D016135:Spinal Dysraphism / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; C583557:IGF1 protein, human; D006710:Homocysteine; D007334:Insulin-Like Growth Factor I; D003404:Creatinine
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