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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 tubulus and
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 waved decrease, and consequently an increase in its urinary elimination would be
observed. 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 (AGE) and IUGR neonates in order to identify its clinical value in IUGR. Urinary Cys-C levels were
measured using the enzyme immunoassay Detect X�® Human Cystatin C kit in IUGR and AGA neonates. Whole renal and renal
cortex volumes were assessed with ultrasounds (Vocal II; Software, GE). Urinary Cys-C levels in UGR were significantly higher than
those found in AGA and were negatively correlated to reduce whole renal and renal cortex volumes. 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 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 monitoring during childhood.