Journal of Clinical & Experimental Pathology
Open Access

Abstract

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.

Biography

Email: chiara2109@virgilio.it