Reference intervals of serum cystatin C/creatinine ratio of 30 postnatal days in neonates

Abstract

A number of recent reports have suggested that the cystatin C/creatinine (CysC/Cr) ratio might be a useful biomarker of renal function in pediatric patients. In this study we investigated the reference intervals of the serum CysC/Cr ratio for neonates including very low birth weight infants. A total of 883 blood samples were collected from 246 neonates during the first 30 days of life for the concurrent measurement of serum CysC and Cr levels. Infants with symptoms or signs of acute kidney injury, systemic illness, congenital anomaly, or renal pathology were excluded. The association between serum CysC/Cr ratio and the subgroups of patients was also analyzed. Reference intervals of serum CysC/Cr ratio were determined according to the postnatal age and post-conceptional age (PCA). CysC/Cr ratio level increased according to PCA, except in the first three postnatal days. The serum CysC/Cr ratio correlated positively with gestational age at birth, birth weight, postnatal age, and PCA, and negatively with serum CysC and Cr (P < 0.001). Reference levels of serum CysC/Cr ratio were determined according to postnatal age and PCA. As the serum CysC/Cr ratio is dependent on several clinical parameters, these should be considered when assessing the serum CysC/Cr ratio in neonates.