Background: Nutritional interventions are crucial to optimal outcomes in preterm neonates. The effect of early high protein administration for preterm neonates on glomerular function remains controversial.
Objectives: The primary objective is to study the effect of protein parenteral nutrition on serum cystatin C as a marker for renal function in preterm neonates. Secondary objectives are to compare the sensitivity of serum cystatin to serum creatinine in acute kidney injury in preterm neonates and to study the effect of protein parenteral nutrition on weight gain.
Subjects and Methods: A case-control study was conducted at the neonatal intensive care units of Ain Shams University Hospital and Manshet El Bakery Hospital. Eighty four preterm neonates 36 weeks gestation or less were enrolled during the period from March 2016 to March 2017; 28 neonates who received enteral feeding and did not receive PPN comprised the control group, 28 neonates received low PPN at Manshet EL Bakery Hospital and 28 neonates received high PPN at Ain Shams University Hospital. Complete blood count, serum creatinine and blood urea nitrogen, serum Na, serum K, pH were measured on day 3 and 7 of life. Serum cystatin C was measured by ELISA on day 7.
Results: On day 7 there were no significant differences regarding serum cystatin C between the high and low PPN groups (P=0.289,). There were no significant differences between the high and low PPN regarding weight gain till day 7.
Conclusion: Neither high nor low protein parenteral nutrition has significant effect on s. Cystatin C consequently high protein parenteral nutrition can be used to minimize weight loss without increasing the risk of metabolic acidosis or renal impairment in preterm neonates.