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Prevalence and progression of chronic kidney disease in adult patients with sickle cell disease.
J Investig Med. 2014 Jun; 62(5):804-7.JI

Abstract

AIM

We evaluated the prevalence and progression of chronic kidney disease (CKD) during the 5-year period in a cohort of patients with sickle cell disease (SCD) aged 18 years and older.

METHODS

We studied 98 patients with SCD. Chronic kidney disease stages I through V were defined based on estimated glomerular filtration rate (eGFR), and albuminuria grades were defined based on spot urine protein-to-creatinine ratio according to the 2012 Kidney Disease Improving Global Outcomes recommendations. In patients with eGFR of greater than 60 mL/min per 1.73 m(2), CKD was diagnosed if grade A2 or A3 albuminuria was present. Chronic kidney disease progression was defined as an increase in CKD stage with an additional eGFR reduction of more than 25% from baseline.

RESULTS

At baseline, 28.6% of patients had CKD. After a mean follow-up of 5.0 (SD, 0.9) years, 17 patients developed new CKD and the overall CKD prevalence increased to 41.8%. In addition, 8 patients experienced CKD progression. The following baseline variables were associated with the development and progression of CKD in univariate analysis: older age (P = 0.003), higher systolic blood pressure (BP; P = 0.003), lower eGFR (P = 0.001), higher serum creatinine (P = 0.001), and A3 albuminuria (P = 0.008). In multivariate analysis, baseline A3 albuminuria (adjusted odds ratio, 5.0; 95% confidence interval, 1.1-24.3; P = 0.048) and each 1-mm Hg increase in systolic BP (adjusted odds ratio, 1.04; 95% confidence interval, 1.0-1.07; P = 0.039) predicted CKD development and progression.

CONCLUSIONS

Chronic kidney disease is common in patients with SCD and its prevalence increases with age. Several baseline modifiable and nonmodifiable factors were associated with the development and progression of CKD in patients with SCD. Strategies targeting BP control and proteinuria may be beneficial for individuals with SCD.

Authors+Show Affiliations

From the Divisions of *Nephrology, and †Hematology, Department of Medicine, and ‡Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

24781553

Citation

Gosmanova, Elvira O., et al. "Prevalence and Progression of Chronic Kidney Disease in Adult Patients With Sickle Cell Disease." Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research, vol. 62, no. 5, 2014, pp. 804-7.
Gosmanova EO, Zaidi S, Wan JY, et al. Prevalence and progression of chronic kidney disease in adult patients with sickle cell disease. J Investig Med. 2014;62(5):804-7.
Gosmanova, E. O., Zaidi, S., Wan, J. Y., & Adams-Graves, P. E. (2014). Prevalence and progression of chronic kidney disease in adult patients with sickle cell disease. Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research, 62(5), 804-7. https://doi.org/10.1097/01.JIM.0000446836.75352.72
Gosmanova EO, et al. Prevalence and Progression of Chronic Kidney Disease in Adult Patients With Sickle Cell Disease. J Investig Med. 2014;62(5):804-7. PubMed PMID: 24781553.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and progression of chronic kidney disease in adult patients with sickle cell disease. AU - Gosmanova,Elvira O, AU - Zaidi,Sahar, AU - Wan,Jim Y, AU - Adams-Graves,Patricia E, PY - 2014/5/1/entrez PY - 2014/5/2/pubmed PY - 2015/4/14/medline SP - 804 EP - 7 JF - Journal of investigative medicine : the official publication of the American Federation for Clinical Research JO - J Investig Med VL - 62 IS - 5 N2 - AIM: We evaluated the prevalence and progression of chronic kidney disease (CKD) during the 5-year period in a cohort of patients with sickle cell disease (SCD) aged 18 years and older. METHODS: We studied 98 patients with SCD. Chronic kidney disease stages I through V were defined based on estimated glomerular filtration rate (eGFR), and albuminuria grades were defined based on spot urine protein-to-creatinine ratio according to the 2012 Kidney Disease Improving Global Outcomes recommendations. In patients with eGFR of greater than 60 mL/min per 1.73 m(2), CKD was diagnosed if grade A2 or A3 albuminuria was present. Chronic kidney disease progression was defined as an increase in CKD stage with an additional eGFR reduction of more than 25% from baseline. RESULTS: At baseline, 28.6% of patients had CKD. After a mean follow-up of 5.0 (SD, 0.9) years, 17 patients developed new CKD and the overall CKD prevalence increased to 41.8%. In addition, 8 patients experienced CKD progression. The following baseline variables were associated with the development and progression of CKD in univariate analysis: older age (P = 0.003), higher systolic blood pressure (BP; P = 0.003), lower eGFR (P = 0.001), higher serum creatinine (P = 0.001), and A3 albuminuria (P = 0.008). In multivariate analysis, baseline A3 albuminuria (adjusted odds ratio, 5.0; 95% confidence interval, 1.1-24.3; P = 0.048) and each 1-mm Hg increase in systolic BP (adjusted odds ratio, 1.04; 95% confidence interval, 1.0-1.07; P = 0.039) predicted CKD development and progression. CONCLUSIONS: Chronic kidney disease is common in patients with SCD and its prevalence increases with age. Several baseline modifiable and nonmodifiable factors were associated with the development and progression of CKD in patients with SCD. Strategies targeting BP control and proteinuria may be beneficial for individuals with SCD. SN - 1708-8267 UR - https://www.unboundmedicine.com/medline/citation/24781553/Prevalence_and_progression_of_chronic_kidney_disease_in_adult_patients_with_sickle_cell_disease_ L2 - https://jim.bmj.com/lookup/pmidlookup?view=long&pmid=24781553 DB - PRIME DP - Unbound Medicine ER -