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Higher rates of hemolysis are not associated with albuminuria in Jamaicans with sickle cell disease.
PLoS One. 2011 Apr 14; 6(4):e18863.Plos

Abstract

BACKGROUND

Albuminuria is a marker of glomerular damage in Sickle Cell Disease (SCD). In this study, we sought to determine the possible predictors of albuminuria in the two more prevalent genotypes of SCD among the Jamaica Sickle Cell Cohort Study participants.

METHODS

An age-matched cohort of 122 patients with HbSS or HbSC genotypes had measurements of their morning urine albumin concentration, blood pressure, body mass index, haematology and certain biochemistry parameters done. Associations of albuminuria with possible predictors including hematological parameters, reticulocyte counts, aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) levels were examined using multiple regression models.

RESULTS

A total of 122 participants were recruited (mean age 28.6 years ±2.5 years; 85 HbSS, 37 HbSC). 25.9% with HbSS and 10.8% with HbSC disease had microalbuminuria (urine albumin/creatinine ratio = 30-300 mg/g of creatinine) whereas 16.5% of HbSS and 2.7% of HbSC disease had macroalbuminuria (urine albumin/creatinine ratio>300 mg/g of creatinine). Mean arterial pressure, hemoglobin levels, serum creatinine, reticulocyte counts and white blood cell counts were statistically significant predictors of albuminuria in HbSS, whereas white blood cell counts and serum creatinine predicted albuminuria in HbSC disease. Both markers of chronic hemolysis, i.e. AST and LDH levels, showed no associations with albuminuria in either genotype.

CONCLUSIONS

Renal disease, as evidenced by excretion of increased amounts of albumin in urine due to a glomerulopathy, is a common end-organ complication in SCD. It is shown to be more severe in those with HbSS disease than in HbSC disease. Rising blood pressure, lower hemoglobin levels and higher white blood cell counts are hints to the clinician of impending renal disease, whereas higher rates of hemolysis do not appear to play a role in this complication of SCD.

Authors+Show Affiliations

Sickle Cell Unit, Tropical Medicine Research Institute, Mona Campus, University of the West Indies, Kingston, Jamaica. monika.parshadasnani@uwimona.edu.jmNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21533141

Citation

Asnani, Monika R., et al. "Higher Rates of Hemolysis Are Not Associated With Albuminuria in Jamaicans With Sickle Cell Disease." PloS One, vol. 6, no. 4, 2011, pp. e18863.
Asnani MR, Fraser RA, Reid ME. Higher rates of hemolysis are not associated with albuminuria in Jamaicans with sickle cell disease. PLoS One. 2011;6(4):e18863.
Asnani, M. R., Fraser, R. A., & Reid, M. E. (2011). Higher rates of hemolysis are not associated with albuminuria in Jamaicans with sickle cell disease. PloS One, 6(4), e18863. https://doi.org/10.1371/journal.pone.0018863
Asnani MR, Fraser RA, Reid ME. Higher Rates of Hemolysis Are Not Associated With Albuminuria in Jamaicans With Sickle Cell Disease. PLoS One. 2011 Apr 14;6(4):e18863. PubMed PMID: 21533141.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Higher rates of hemolysis are not associated with albuminuria in Jamaicans with sickle cell disease. AU - Asnani,Monika R, AU - Fraser,Raphael A, AU - Reid,Marvin E, Y1 - 2011/04/14/ PY - 2010/11/08/received PY - 2011/03/21/accepted PY - 2011/5/3/entrez PY - 2011/5/3/pubmed PY - 2011/8/31/medline SP - e18863 EP - e18863 JF - PloS one JO - PLoS One VL - 6 IS - 4 N2 - BACKGROUND: Albuminuria is a marker of glomerular damage in Sickle Cell Disease (SCD). In this study, we sought to determine the possible predictors of albuminuria in the two more prevalent genotypes of SCD among the Jamaica Sickle Cell Cohort Study participants. METHODS: An age-matched cohort of 122 patients with HbSS or HbSC genotypes had measurements of their morning urine albumin concentration, blood pressure, body mass index, haematology and certain biochemistry parameters done. Associations of albuminuria with possible predictors including hematological parameters, reticulocyte counts, aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) levels were examined using multiple regression models. RESULTS: A total of 122 participants were recruited (mean age 28.6 years ±2.5 years; 85 HbSS, 37 HbSC). 25.9% with HbSS and 10.8% with HbSC disease had microalbuminuria (urine albumin/creatinine ratio = 30-300 mg/g of creatinine) whereas 16.5% of HbSS and 2.7% of HbSC disease had macroalbuminuria (urine albumin/creatinine ratio>300 mg/g of creatinine). Mean arterial pressure, hemoglobin levels, serum creatinine, reticulocyte counts and white blood cell counts were statistically significant predictors of albuminuria in HbSS, whereas white blood cell counts and serum creatinine predicted albuminuria in HbSC disease. Both markers of chronic hemolysis, i.e. AST and LDH levels, showed no associations with albuminuria in either genotype. CONCLUSIONS: Renal disease, as evidenced by excretion of increased amounts of albumin in urine due to a glomerulopathy, is a common end-organ complication in SCD. It is shown to be more severe in those with HbSS disease than in HbSC disease. Rising blood pressure, lower hemoglobin levels and higher white blood cell counts are hints to the clinician of impending renal disease, whereas higher rates of hemolysis do not appear to play a role in this complication of SCD. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/21533141/Higher_rates_of_hemolysis_are_not_associated_with_albuminuria_in_Jamaicans_with_sickle_cell_disease_ L2 - https://dx.plos.org/10.1371/journal.pone.0018863 DB - PRIME DP - Unbound Medicine ER -