Tags

Type your tag names separated by a space and hit enter

Chronic kidney disease and albuminuria in children with sickle cell disease.
Clin J Am Soc Nephrol. 2011 Nov; 6(11):2628-33.CJ

Abstract

BACKGROUND AND OBJECTIVES

Sickle cell nephropathy begins in childhood and may progress to renal failure. Albuminuria is a sensitive marker of glomerular damage that may indicate early chronic kidney disease (CKD).

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

The aims of this study were to determine the cross-sectional prevalence and clinical correlates of albuminuria and CKD among children with sickle cell disease (SCD). Over a 10-year period (1995 to 2005) 410 pediatric SCD patients ages 2 to 21 years were enrolled: 261 with hemoglobin SS (HbSS) or HbSβ(0) thalassemia (HbSβ(0)) and 149 with HbSC or HbSβ(+) thalassemia (HbSβ(+)). The albumin/creatinine ratio (ACR) of spot-urine specimens and serum creatinine were measured; abnormal albuminuria was defined as urinary ACR ≥ 30 mg/g.

RESULTS

The prevalence of abnormal albuminuria was 20.7% (23.0% in HbSS/HbSβ(0), 16.8% in HbSC/HbSβ(+)). Among HbSS/HbSβ(0), abnormal albuminuria was associated with increasing age and lower baseline hemoglobin. GFR, estimated in 189 patients using the updated Schwartz formula, correlated negatively with age (r = -0.27, P = 0.0002). CKD defined according to the Kidney Disease: Improving Global Outcomes study was present in 26.5% (50 of 189) of patients: stage 1 in 27 (14.8%) and stage 2 in 22 (11.6%). In multivariate analysis, age and HbSC/HbSβ(+) genotype were associated with CKD.

CONCLUSIONS

This is the first study to stage CKD in children with SCD and highlights a high prevalence of albuminuria and glomerular injury early in life. Detecting CKD in childhood could allow for earlier intervention and prevention of renal failure in adulthood.

Authors+Show Affiliations

Department of Pediatrics, Division of Hematology/Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA. Marianne.McPherson@choa.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21940843

Citation

McPherson Yee, Marianne, et al. "Chronic Kidney Disease and Albuminuria in Children With Sickle Cell Disease." Clinical Journal of the American Society of Nephrology : CJASN, vol. 6, no. 11, 2011, pp. 2628-33.
McPherson Yee M, Jabbar SF, Osunkwo I, et al. Chronic kidney disease and albuminuria in children with sickle cell disease. Clin J Am Soc Nephrol. 2011;6(11):2628-33.
McPherson Yee, M., Jabbar, S. F., Osunkwo, I., Clement, L., Lane, P. A., Eckman, J. R., & Guasch, A. (2011). Chronic kidney disease and albuminuria in children with sickle cell disease. Clinical Journal of the American Society of Nephrology : CJASN, 6(11), 2628-33. https://doi.org/10.2215/CJN.01600211
McPherson Yee M, et al. Chronic Kidney Disease and Albuminuria in Children With Sickle Cell Disease. Clin J Am Soc Nephrol. 2011;6(11):2628-33. PubMed PMID: 21940843.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic kidney disease and albuminuria in children with sickle cell disease. AU - McPherson Yee,Marianne, AU - Jabbar,Shameem F, AU - Osunkwo,Ifeyinwa, AU - Clement,Lisa, AU - Lane,Peter A, AU - Eckman,James R, AU - Guasch,Antonio, Y1 - 2011/09/22/ PY - 2011/9/24/entrez PY - 2011/9/24/pubmed PY - 2012/3/1/medline SP - 2628 EP - 33 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 6 IS - 11 N2 - BACKGROUND AND OBJECTIVES: Sickle cell nephropathy begins in childhood and may progress to renal failure. Albuminuria is a sensitive marker of glomerular damage that may indicate early chronic kidney disease (CKD). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The aims of this study were to determine the cross-sectional prevalence and clinical correlates of albuminuria and CKD among children with sickle cell disease (SCD). Over a 10-year period (1995 to 2005) 410 pediatric SCD patients ages 2 to 21 years were enrolled: 261 with hemoglobin SS (HbSS) or HbSβ(0) thalassemia (HbSβ(0)) and 149 with HbSC or HbSβ(+) thalassemia (HbSβ(+)). The albumin/creatinine ratio (ACR) of spot-urine specimens and serum creatinine were measured; abnormal albuminuria was defined as urinary ACR ≥ 30 mg/g. RESULTS: The prevalence of abnormal albuminuria was 20.7% (23.0% in HbSS/HbSβ(0), 16.8% in HbSC/HbSβ(+)). Among HbSS/HbSβ(0), abnormal albuminuria was associated with increasing age and lower baseline hemoglobin. GFR, estimated in 189 patients using the updated Schwartz formula, correlated negatively with age (r = -0.27, P = 0.0002). CKD defined according to the Kidney Disease: Improving Global Outcomes study was present in 26.5% (50 of 189) of patients: stage 1 in 27 (14.8%) and stage 2 in 22 (11.6%). In multivariate analysis, age and HbSC/HbSβ(+) genotype were associated with CKD. CONCLUSIONS: This is the first study to stage CKD in children with SCD and highlights a high prevalence of albuminuria and glomerular injury early in life. Detecting CKD in childhood could allow for earlier intervention and prevention of renal failure in adulthood. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/21940843/Chronic_kidney_disease_and_albuminuria_in_children_with_sickle_cell_disease_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=21940843 DB - PRIME DP - Unbound Medicine ER -