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Change of Scr and inter-individual variability was characterized with nonlinear mixed-effect modeling. Key covariates such as gestational age (GA), mode of delivery (MOD), and treatment with ibuprofen or inotropic agents were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2814 Scr concentrations were analyzed. GA was associated with Scr at birth (higher with advancing GA), and GA and MOD showed an association with postnatal maturation of CLcr (faster clearance increase with advancing GA and after C-section). Small CLcr decrease (\u2264\u20095%) was quantified during ibuprofen treatment. For a GA of 27\u00a0weeks, mean Scr (estimated CLcr) at birth was 0.61\u00a0mg\/dl (0.23\u00a0ml\/min), increasing to 0.87\u00a0mg\/dl (0.27\u00a0ml\/min) at day three, and decreasing to 0.36\u00a0mg\/dl (0.67\u00a0ml\/min) at day 42 after birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We report the first mathematical model able to characterize Scr and CLcr in ELBW neonates during the first 6\u00a0weeks of life in a quantitative manner as a function of GA, MOD, and ibuprofen treatment. This model allows the derivation of GA-adjusted reference ranges for ELBW neonates and provides a rationale for normative Scr concentrations, and as such will help clinicians to further optimize monitoring and treatment decisions in this vulnerable patient population.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00467-020-04749-3","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T22:02:31Z","timestamp":1600380151000},"page":"649-659","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Characterizing dynamics of serum creatinine and creatinine clearance in extremely low birth weight neonates during the first 6 weeks of life"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4607-3179","authenticated-orcid":false,"given":"Tamara","family":"van Donge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karel","family":"Allegaert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Gotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Smits","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Levtchenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djalila","family":"Mekahli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"van den Anker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Pfister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,17]]},"reference":[{"key":"4749_CR1","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1373\/clinchem.2012.183483","volume":"58","author":"F Ceriotti","year":"2012","unstructured":"Ceriotti F (2012) Establishing pediatric reference intervals: a challenging task. 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