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Thursday, 05 May 2016 00:32

Clinical Research: Relationship of gestational age and birth-weight with novel Urinary Biomarkers of renal function measured at 5 and 7 years of age

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image jaimeName: Jaime Manuel Restrepo

Hospital / Affiliation: Fundación Clínica Valle del Lili/Working with Boston Children's Hospital in SRC program

Home Country: Colombia

Host Country: USA

Year: 2010

Status of your program: IN PROGRESS

 

 

Title of the project:

Relationship of gestational age and birth-weight with novel Urinary Biomarkers of renal function measured
at 5 and 7 years of age in children on follow up at program Kangoroo Mother House Alfa, Cali Colombia

Topic: 

Pediatric Nephrology

 

Short description of the project or abstract:

Nowadays, the low weight and height newborn (preterm or with intrauterine growth restriction) is considered as a public health problem. It is estimated that nearly 13.7 million term newborns fall in the low birth weight category, standing for 11% of all newborns in developed countries. Intrauterine Growth Restriction (IUGR), taken as a birth weight below the 10th percentile, accounts for 75% of infant mortality.
In Cali, Low Birth Weight accounts for 11.9% of all newborns and contributes with 80% of neonatal deaths, 38% of which can be classified as IUGR.
Prematurity and IUGR are relevant not only for their contribution to perinatal and neonatal mortality, but also for their implications to the growth and development and quality of life in posterior years.
Extreme Prematures (<1000 gm), usually also less than 30 weeks gestational age, have a lower number of glomeruli and thus would be at a major risk of glomerular lesion, including also inadequate nutrition and nephrotoxic medication.

We are in need for new biomarkers to classify patients on risk for AKI to CKD progression. There are desirable properties of these biomarkers: Noninvasive wit easy accessibility to take samples like urine and blood ; early to perform ; sensitive, minimizing false negative ;specific to minimize false positives and predictive, predicting CKD progression.
Main Objective: To describe a relationship between gestacional age and birth-weight with both traditional and new urinary biomarkers of renal function measured in children with 5 and 7 years of age from the program Kangoroo Mother House Alfa, Cali.
Specific Objectives: To correlate serum creatinine, uric acid, urinary Prot/Creat, FENa, Fek, Fep, urinary osmolarity, and renal ultrasonid in children 5 and 7 years old with their birth-weight and gestational age, to correlate urinary IL-18, N-GAL, KIM-1 and L-FABP in children 5 and 7 years old with their birth-weight and gestational age, to adjust the described correlations for covariates, such as anthropometrical measurements and gender.
Study design: This is a descriptive study, where there is going to be a transversal cut by age group; it is planned to take children about 5 and 7 years of age (±3 months), and to apply to them the measurements and variables proposed. Because we expect around 150 children for each age group, we expect to recruit 100 subjects for these age groups. Measurements of the variables of renal function and values of blood pressure will be stratified by weight at birth and gestational age.
Inclusion Criteria: Patients admitted and being followed up by the program Kangoroo Mother House Alfa – Cali belonging to 5 and 7 years of age (±3 months), with information on their weight and gestational age, without congenital abnormalities, without renal abnormalities, consent from the parents to participate

Exclusion Criteria: Ages less nine and higher sixty three months old, without appropiate information on their weight and gestational age, non consent from the parents to participate, presence of congenital abnormalities and/or evidence of chronic renal failure, children who are receiving nephrotoxic drugs ( furosemide, AINES, aminoglucosides).

 

Learning or Research objectives:

Specific Objectives

  • To correlate serum creatinine, uric acid, urinary Prot/Creat, FENa, Fek, Fep, urinary osmolarity, and renal ultrasonid in children 5 and 7 years old with their birth-weight and gestational age.
  • To correlate urinary IL-18, N-GAL, KIM-1 and L-FABP in children 5 and 7 years old with their birth-weight and gestational age.
  • To adjust the described correlations for covariates, such as anthropometrical measurements and gender.

Advances of proyect 2015-2016:
In 2015 we sent the orine´s samples to Boston, we have recruited control patients for the 5 and 7 year old group, and we completed 7 cases patient because 7 of these patients left the study without making laboratories. 64 patients have been enrolled this year so far, 15 of these didn´t complete the study, today we have in total 146 patients: 100 cases of 5 year old, 23 controls of 5 year old, 18 cases of 7 year old and 5 controls of 7 year old. We changed the number required for controls to 60, due to difficulties with their recruitment in the local community. It has been a real challenge to get them. We have visited 6 public schools and 4 private schools looking for healthy patients to recruit. With help of school we are confident that we will achieve complete sample in the next 3 months.

 

Additional Info

  • Year: 2010
  • Status: In progress
  • Partners: ISN only
  • Region: Latin America and the Caribbean
  • Country: Colombia
  • Topics: Paediatric nephrology
Read 6658 times Last modified on Tuesday, 10 May 2016 08:01

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