Title:Nephrogenesis, Renal Function, and Biomarkers in Preterm Newborns
Volume: 29
Issue: 23
Author(s): Luísa Petri Corrêa, Felipe Rodrigues Gatto, Guilherme Yanq Sen Bressani, Katharina Lanza and Ana Cristina Simões e Silva*
Affiliation:
- Laboratory of Medical Investigation, Department of Pediatrics, Faculty of Medicine, Federal University of
Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
Keywords:
Preterm newborns, renal function, urinary biomarkers, nephrogenesis, acute kidney injury, low gestational age.
Abstract:
Background: The survival of premature newborns increased in the last decades
due to advances in neonatal care. The physiology of this group is still under investigation,
once the incomplete organogenesis entails functional particularities that are not yet clarified
by current clinical knowledge. The immature kidneys are especially susceptible to
acute injury with potential long-term impacts. Current diagnostic parameters of acute kidney
injury are limited among the preterm population. The commonly used serum creatinine
protein constitutes a poor biomarker to predict early lesions as it is susceptible to
several factors, including muscle mass and gestational age.
Objective: The present review explores the evidence on nephrogenesis, renal function,
and acute kidney injury in neonatology, as well as studies on renal function biomarkers
and their potential application for diagnosis, follow-up, and prognosis in preterm newborns.
Results: Premature newborns reach full-term gestational age with reduced number and
quality of nephrons. Consequently, the glomerular filtration rate and tubular function become
impaired and are proportional to the gestational age. Despite having a high incidence
among the pediatric population, acute kidney injury is still underdiagnosed and
poorly managed due to the absence of proper, sensible, and non-invasive biomarkers. Although
cystatin C, NGAL, and KIM-1, are promising urinary markers, current literature
remains inconsistent.
Conclusion: Further research is needed to properly identify and standardize sensible and
specific urinary biomarkers to better assess kidney function in preterm newborns.
