title: Increased Urinary Cystatin-C Levels Correlate with Reduced Renal Volumes in Neonates with Intrauterine Growth Restriction.
abstract: BACKGROUND
  Exposure to intrauterine growth retardation (IUGR) can have a negative impact on nephrogenesis resulting in limited fetal kidney development and supporting the hypothesis that IUGR represents a risk for renal function and long-term renal disease. Cystatin-C (Cys-C), a strong inhibitor of cysteine proteinases, is freely filtered by the kidney glomerulus and is reabsorbed by the tubules, where it is almost totally catabolized; what remains is subsequently eliminated in urine. In tubular diseases and in hyperfiltration conditions, it seems reasonable to postulate that Cys-C degradation would decrease, and consequently an increase in its urinary elimination would be observed.
  
  
  OBJECTIVE
  The aim of this study was to investigate the urinary excretion of Cys-C simultaneously with the assessment of renal volumes in adequate for gestational age (AGA) and IUGR neonates in order to identify its clinical value in IUGR.
  
  
  METHODS
  Urinary Cys-C levels were measured using the enzyme immunoassay DetectX® Human Cystatin C kit in IUGR and AGA neonates. Whole renal and renal cortex volumes were assessed with ultrasounds (Vocal II; Software, GE).
  
  
  RESULTS
  Urinary Cys-C levels in IUGR were significantly higher than those found in AGA and were negatively correlated to reduced whole renal and renal cortex volumes.
  
  
  CONCLUSIONS
  The increased levels of Cys-C in the urine of neonates with IUGR were significantly associated with reduced renal/renal cortex volumes, suggesting that Cys-C could be taken as a surrogate of nephron mass. It also could be used as an early biochemical marker to identify IUGR neonates at high risk of developing long-term renal disease and to select patients for monitoring during childhood.
authors.affiliation: Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, Perugia, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Barbati
authors.forename: Benito
authors.initials: B
authors.lastname: Cappuccini
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Aisa
authors.forename: Chiara
authors.initials: C
authors.lastname: Grasselli
authors.forename: Mariarosalba
authors.initials: M
authors.lastname: Zamarra
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bini
authors.forename: Gianni
authors.initials: G
authors.lastname: Bellomo
authors.forename: Aldo
authors.initials: A
authors.lastname: Orlacchio
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Di Renzo
mesh_terms: D015415:Biomarkers / Q000652:urine; D055316:Cystatin C / Q000652:urine*; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000473:pathology / Q000652:urine*; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology*; D007672:Kidney Cortex / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D009929:Organ Size; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D055316:Cystatin C