Skip Navigation LinksHome > March 2013 - Volume 14 - Issue 3 > Measuring Cystatin C to Determine Renal Function in Neonates
Pediatric Critical Care Medicine:
doi: 10.1097/PCC.0b013e318271f4a5
Review Article

Measuring Cystatin C to Determine Renal Function in Neonates

Kandasamy, Yogavijayan FRACP1; Smith, Roger FRACP2; Wright, Ian M. R. FRACP2

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Abstract

Objectives: The incidence of acute kidney injury in neonates is high and associated with up to a 50% mortality rate. The purpose of this review was to determine the feasibility of using serum cystatin C measurements to assist clinicians in making early and accurate diagnoses of acute kidney injury in neonates.

Data Source: We searched for the following seven key words within the PubMed database and the Cochrane Database of Systematic Reviews: cystatin C, neonates, newborn, preterm, premature, kidney failure, and kidney injury.

Study Selection: The selected studies included neonates within their study populations and were published in English. We reviewed literature published between January 1990 and May 2012.

Data Extraction: Ten studies had conducted serum cystatin C measurements in neonates.

Data Synthesis: The cystatin C level in neonates is not influenced by the maternal level and is highest at birth. In most studies, cystatin C levels on day 1 of life ranged between 1 and 2 mg/L, gradually declined during the first year and then remained relatively stable thereafter. Cystatin C levels did not differ between male and female infants, and no significant gestational age-dependent differences were found. Cystatin C levels were increased in cases of sepsis, acute kidney injury, and congenital renal abnormalities.

Conclusions: Cystatin C has all of the theoretical properties needed to be an ideal marker of renal function. It can be used to determine baseline renal function on day 1 and is increasingly being used to determine renal function in sick neonates. In the majority of studies, the day 1 cystatin C level ranged between 1 and 2 mg/L, which gradually declined in the first year of life. However, the number of available studies evaluating cystatin C in sick neonates is currently limited, and there are also no studies linking cystatin C levels in sick babies with short-term and long-term outcomes.

©2013The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

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