Assessment of renal functional maturation and injury in preterm neonates during the first month of life

2014 ◽  
Vol 307 (2) ◽  
pp. F149-F158 ◽  
Author(s):  
Lina Gubhaju ◽  
Megan R. Sutherland ◽  
Rosemary S. C. Horne ◽  
Alison Medhurst ◽  
Alison L. Kent ◽  
...  

Worldwide, approximately 10% of neonates are born preterm. The majority of preterm neonates are born when the kidneys are still developing; therefore, during the early postnatal period renal function is likely reflective of renal immaturity and/or injury. This study evaluated glomerular and tubular function and urinary neutrophil gelatinase-associated lipocalin (NGAL; a marker of renal injury) in preterm neonates during the first month of life. Preterm and term infants were recruited from Monash Newborn (neonatal intensive care unit at Monash Medical Centre) and Jesse McPherson Private Hospital, respectively. Infants were grouped according to gestational age at birth: ≤28 wk ( n = 33), 29–31 wk ( n = 44), 32–36 wk ( n = 32), and term (≥37 wk ( n = 22)). Measures of glomerular and tubular function were assessed on postnatal days 3–7, 14, 21, and 28. Glomerular and tubular function was significantly affected by gestational age at birth, as well as by postnatal age. By postnatal day 28, creatinine clearance remained significantly lower among preterm neonates compared with term infants; however, sodium excretion was not significantly different. Pathological proteinuria and high urinary NGAL levels were observed in a number of neonates, which may be indicative of renal injury; however, there was no correlation between the two markers. Findings suggest that neonatal renal function is predominantly influenced by renal maturity, and there was high capacity for postnatal tubular maturation among preterm neonates. There is insufficient evidence to suggest that urinary NGAL is a useful marker of renal injury in the preterm neonate.

PEDIATRICS ◽  
1991 ◽  
Vol 87 (5) ◽  
pp. 675-679
Author(s):  
Shaista S. Usmani ◽  
Jerrold S. Schlessel ◽  
Concepcion G. Sia ◽  
Shahid Kamran ◽  
Shahnaz D. Orner

In this study, effect of chronologic age on polymorphonuclear leukocyte (PMN) chemiluminescence and random and chemotactic motility was evaluated in 38 stable preterm neonates of less than 32 weeks' gestation during the first month of life. Chemiluminescence and random and chemotactic motility of PMNs from preterm neonates were first evaluated at mean postnatal age of 9.8 days and then weekly for an ensuing 21-day period. For comparison, one blood sample was obtained for PMN functions from 14 healthy term neonates younger than 72 hours of age and seven normal adults. On day 1 PMN chemiluminescence and random and chemotactic motility values in preterm neonates were significantly lower (P < .001) compared with those in term neonates and PMN function values of term neonates were significantly lower (P < .001) than those of adults. Although initial PMN chemiluminescence and random and chemotactic motility values in preterm neonates were depressed, subsequent values on days 7, 14, and 21 increased significantly (P < .002). On day 21 (mean postnatal age of 30.8 days) no differences existed in chemiluminescent activity and random motility between preterm and term neonates; chemotactic motility in preterm neonates, however, remained impaired. Mean cumulative age (gestational age at birth plus postnatal age) of preterm neonates on day 21 of study was 32.5 weeks, suggesting that chronologic age has more effect on maturational changes in PMN functions than gestational age.


2015 ◽  
Vol 39 (3) ◽  
pp. 192-197 ◽  
Author(s):  
Lianne Verbeek ◽  
Femke Slaghekke ◽  
Romain Favre ◽  
Marine Vieujoz ◽  
Francesco Cavigioli ◽  
...  

Objective: To evaluate the short-term renal function in neonates with twin anemia-polycythemia sequence (TAPS). Methods: All consecutive monochorionic twins with TAPS with double survivors admitted to three European centers were included in this retrospective study. Each twin pair was matched for gestational age at birth with a control twin pair unaffected by TAPS or twin-twin transfusion syndrome. Creatinine and urea levels in the first week after birth were recorded. Short-term postnatal renal dysfunction was defined as creatinine >100 μmol/l during the first week after birth. Results: A total of 52 TAPS twin pairs and 52 control twin pairs with a median gestational age of 31 weeks at birth were included in the study. In the TAPS group, donors had higher mean creatinine levels compared to recipients, 85 versus 71 μmol/l, respectively (p = 0.001). Short-term renal dysfunction was detected in 26.0% (13/50) of the donors versus 6.3% (3/48) of the recipients (p = 0.022). In the control group, no inter-twin differences in creatinine levels were found. Conclusions: Donor twins with TAPS have higher creatinine levels than recipient twins, suggesting that chronic inter-twin transfusion in TAPS may also cause short-term renal dysfunction. Long-term renal consequences in TAPS donors require further investigation.


2013 ◽  
Vol 47 (5) ◽  
pp. 1046-1051 ◽  
Author(s):  
Larissa Paiva Silva ◽  
Polyana Candeia Maia ◽  
Marcia Maria Coelho Oliveira Lopes ◽  
Maria Vera Lucia Moreira Leitao Cardoso

This study had as its objective to analyze the intraclass reliability of the Alberta Infant Motor Scale (AIMS), in the Brazilian version, in preterm and term infants. It was a methodological study, conducted from November 2009 to April 2010, with 50 children receiving care in two public institutions in Fortaleza, Ceará, Brazil. Children were grouped according to gestational age as preterm and term, and evaluated by three evaluators in the communication laboratory of a public institution or at home. The intraclass correlation indices for the categories prone, supine, sitting and standing ranged from 0.553 to 0.952; most remained above 0.800, except for the standing category of the third evaluator, in which the index was 0.553. As for the total score and percentile, rates ranged from 0.843 to 0.954. The scale proved to be a reliable instrument for assessing gross motor performance of Brazilian children, particularly in Ceará, regardless of gestational age at birth.


2021 ◽  
Vol 155 ◽  
pp. 106659
Author(s):  
Ashlinn K. Quinn ◽  
Irene Apewe Adjei ◽  
Kenneth Ayuurebobi Ae-Ngibise ◽  
Oscar Agyei ◽  
Ellen Abrafi Boamah-Kaali ◽  
...  

2021 ◽  
pp. 004947552199134
Author(s):  
Avinash Lomash ◽  
Abhinaya Venkatakrishnan ◽  
Meenakshi Bothra ◽  
Bhavna Dhingra ◽  
Praveen Kumar ◽  
...  

Atypical coeliac disease in young children is frequently missed when it presents atypically as non-gastrointestinal presentations to different specialties. There was a greater delay (54 months) in establishing the diagnosis in those with atypical coeliac disease (p < 0.001). No difference was observed in the mode of delivery or duration of breast feeding, but significant difference was observed between gestational age at birth (p < 0.001). Most cases showed stunted growth and underweight. Irritability, anaemia, rickets, dermatitis herpetiformis, alopecia and intussusception were other common predictors of atypical coeliac disease. Because of a myriad spectrum of non-gastrointestinal symptoms, at any age with diverse presentation, a high index of suspicion is therefore required.


1989 ◽  
Vol 69 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Nigel Foreman ◽  
Alistair Fielder

The interaction of auditory and visual modalities in the enhancement of orientation was examined in premature and near-term infants by presenting them auditory or visual stimuli or auditory-visual stimulus combinations at various positions in sensory space. In 4.5–15-mo.-olds, brisk orienting responses could be elicited to very peripheral stimulus positions but only when the stimulus consisted of a spatially coherent auditory-visual combination (i.e., where a sound and a light occurred at the same point in space). This occurred for all infants, irrespective of age or gestational age at birth. First, the result shows that infants can respond to visual stimuli at eccentric positions, beyond the supposed limits of their effective visual fields as measured by standard perimetry. Second, the result extends earlier studies showing that intersensory integration and stimulus localisation develop relatively normally in prematurely born infants. The auditory-visual enhancement test as used here may have a number of further uses and applications in the clinic and laboratory.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eva E. Lancaster ◽  
Dana M. Lapato ◽  
Colleen Jackson-Cook ◽  
Jerome F. Strauss ◽  
Roxann Roberson-Nay ◽  
...  

AbstractMaternal age is an established predictor of preterm birth independent of other recognized risk factors. The use of chronological age makes the assumption that individuals age at a similar rate. Therefore, it does not capture interindividual differences that may exist due to genetic background and environmental exposures. As a result, there is a need to identify biomarkers that more closely index the rate of cellular aging. One potential candidate is biological age (BA) estimated by the DNA methylome. This study investigated whether maternal BA, estimated in either early and/or late pregnancy, predicts gestational age at birth. BA was estimated from a genome-wide DNA methylation platform using the Horvath algorithm. Linear regression methods assessed the relationship between BA and pregnancy outcomes, including gestational age at birth and prenatal perceived stress, in a primary and replication cohort. Prenatal BA estimates from early pregnancy explained variance in gestational age at birth above and beyond the influence of other recognized preterm birth risk factors. Sensitivity analyses indicated that this signal was driven primarily by self-identified African American participants. This predictive relationship was sensitive to small variations in the BA estimation algorithm. Benefits and limitations of using BA in translational research and clinical applications for preterm birth are considered.


2018 ◽  
Vol 218 (1) ◽  
pp. S306-S307
Author(s):  
Nathan R. Blue ◽  
Mariam Savabi ◽  
Meghan E. Beddow ◽  
Vivek R. Katukuri ◽  
Cody M. Fritts ◽  
...  

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