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Distribution of proteinuria- and albuminuria-to-creatinine ratios in preterm newborns

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Abstract

Background

Urine protein assessment is important when glomerular disease or injury is suspected. Normal values of proteinuria already published for preterm newborns suffer from limitation, with small cohorts of patients. This prospective study was conducted to update the urine total protein- and albumin-to-creatinine ratio values.

Methods

Urine samples were collected from 231 preterm newborns within the first 48 h (D0–1) and/or between 72–120 h of life (D3–4). Total protein, albumin, and creatinine were measured, their distribution and upper-limit values determined.

Results

At D0–1 and D3–4, respectively, the median for the total protein-to-creatinine ratio were 80 and 107 mg/mmol (upper-limit values 223 and 289 mg/mmol) in the whole studied population, 149 and 214 mg/mmol in children born before 29 weeks of gestational age, 108 and 130 mg/mmol in those born between 29 and 33 weeks, and 61 and 93 mg/mmol in those born after 33 weeks. For the albumin-to-creatinine ratio, the median were 12 and 17 mg/mmol (upper-limit values 65 and 62 mg/mmol) in the whole studied population, 22 and 50 mg/mmol in children born before 29 weeks, 21 mg/mmol in those born between 29 and 33 weeks, and 8 and 12 mg/mmol in those born after 33 weeks. The use of nephrotoxic drugs and mechanical ventilation seems to influence proteinuria and albuminuria values.

Conclusions

We report distribution of proteinuria- and albuminuria-to-creatinine in preterm newborns, including the upper-limit values. These values should be taken into account in the detection and diagnosis of glomerular disease and/or injury in daily clinical practice.

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Abbreviations

D:

Days

g:

Grams

GA:

Gestational age

IUGR:

Intrauterine growth restriction

mg:

Milligrams

mmol:

Millimole

ULV:

Upper-limit values

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Acknowledgments

The authors would like to thank all the nurses and nursing auxiliary staff of the neonatal unit and NICU for collecting samples. We also thank Dr. Sylvie Bourthoumieu, Dr. Valentine Marquet, and the CRBioLim for their technical support.

Funding

This work was supported by grants from the Conseil Régional, Limousin, France.

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Author notes

  1. Laure Ponthier and Marine Trigolet contributed equally to this work.

Authors and Affiliations

  1. Collection Biologique Hôpital de la Mère et de l’Enfant (CB-HME), University Hospital Center, 8 Avenue Dominique Larrey, 87042 Cedex, Limoges, France

    Laure Ponthier, Catherine Yardin, Vincent Guigonis & Chahrazed El Hamel

  2. Department of Pediatric, University Hospital Center, Limoges, France

    Laure Ponthier, Marine Trigolet, Fabienne Mons, Vincent Guigonis & Chahrazed El Hamel

  3. Department of Biochemistry, University Hospital Center, Limoges, France

    Thierry Chianea

  4. Department of Cytogenetics and clinical genetics, University Hospital Center, Limoges, France

    Catherine Yardin

  5. CNRS, XLIM, UMR7252, Limoges University, Limoges, France

    Catherine Yardin

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  1. Laure Ponthier
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  2. Marine Trigolet
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Correspondence to Chahrazed El Hamel.

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Ponthier, L., Trigolet, M., Chianea, T. et al. Distribution of proteinuria- and albuminuria-to-creatinine ratios in preterm newborns. Pediatr Nephrol 36, 1515–1524 (2021). https://doi.org/10.1007/s00467-020-04838-3

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  • DOI: https://doi.org/10.1007/s00467-020-04838-3

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