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Renal function in adult Jamaicans with homozygous sickle cell disease.
Hematology. 2015 Aug; 20(7):422-8.H

Abstract

OBJECTIVES

As populations with sickle cell disease (SCD) live longer, it is likely that the burden of renal dysfunction will be an increasing challenge for patients. In this study, we aim to determine the prevalence of renal dysfunction and its possible predictors in persons with SCD.

METHODS

Ninety-eight patients with the homozygous SCD (SS disease;55 females, 43 males; mean age 34 ± 2.3 years) in their steady state had measurements of glomerular filtration rate (GFR) using 99mTc-DTPA nuclear renal scan, serum creatinine, and urinary albumin: creatinine ratio. Other haematological and biochemical measurements and data on clinical events were completed for each individual.

RESULTS

Chronic kidney disease (CKD) stages 3 and above was present in 6% of the study population, and 65.3% had albuminuria. Hyperfiltration occurred in 24.5% patients with two-thirds having albuminuria as well. Serum creatinine was an insensitive marker of renal dysfunction as started rising after measured GFR fell below 50 mls/min/1.73 m(2). Multiple regression modelling showed serum creatinine and height to be significantly associated with GFR. Serum creatinine was also significantly associated with albuminuria, and age was not a predictor in any of the models. There was no association with markers of haemolysis.

CONCLUSION

We conclude that the burden of renal dysfunction is quite high in this young cohort with SS disease. Serum creatinine is a late and insensitive marker of worsening glomerular function, and screening for albuminuria could begin early in life. Longitudinal studies will continue to increase our understanding of pathophysiological mechanisms that lead to CKD in this specific population.

Authors

No affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

25431929

Citation

Asnani, Monika R., and Marvin E. Reid. "Renal Function in Adult Jamaicans With Homozygous Sickle Cell Disease." Hematology (Amsterdam, Netherlands), vol. 20, no. 7, 2015, pp. 422-8.
Asnani MR, Reid ME. Renal function in adult Jamaicans with homozygous sickle cell disease. Hematology. 2015;20(7):422-8.
Asnani, M. R., & Reid, M. E. (2015). Renal function in adult Jamaicans with homozygous sickle cell disease. Hematology (Amsterdam, Netherlands), 20(7), 422-8. https://doi.org/10.1179/1607845414Y.0000000213
Asnani MR, Reid ME. Renal Function in Adult Jamaicans With Homozygous Sickle Cell Disease. Hematology. 2015;20(7):422-8. PubMed PMID: 25431929.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Renal function in adult Jamaicans with homozygous sickle cell disease. AU - Asnani,Monika R, AU - Reid,Marvin E, Y1 - 2014/11/28/ PY - 2014/11/29/entrez PY - 2014/11/29/pubmed PY - 2016/4/28/medline KW - Albuminuria KW - Chronic kidney disease KW - Glomerular filtration rate KW - Hyperfiltration KW - SS disease SP - 422 EP - 8 JF - Hematology (Amsterdam, Netherlands) JO - Hematology VL - 20 IS - 7 N2 - OBJECTIVES: As populations with sickle cell disease (SCD) live longer, it is likely that the burden of renal dysfunction will be an increasing challenge for patients. In this study, we aim to determine the prevalence of renal dysfunction and its possible predictors in persons with SCD. METHODS: Ninety-eight patients with the homozygous SCD (SS disease;55 females, 43 males; mean age 34 ± 2.3 years) in their steady state had measurements of glomerular filtration rate (GFR) using 99mTc-DTPA nuclear renal scan, serum creatinine, and urinary albumin: creatinine ratio. Other haematological and biochemical measurements and data on clinical events were completed for each individual. RESULTS: Chronic kidney disease (CKD) stages 3 and above was present in 6% of the study population, and 65.3% had albuminuria. Hyperfiltration occurred in 24.5% patients with two-thirds having albuminuria as well. Serum creatinine was an insensitive marker of renal dysfunction as started rising after measured GFR fell below 50 mls/min/1.73 m(2). Multiple regression modelling showed serum creatinine and height to be significantly associated with GFR. Serum creatinine was also significantly associated with albuminuria, and age was not a predictor in any of the models. There was no association with markers of haemolysis. CONCLUSION: We conclude that the burden of renal dysfunction is quite high in this young cohort with SS disease. Serum creatinine is a late and insensitive marker of worsening glomerular function, and screening for albuminuria could begin early in life. Longitudinal studies will continue to increase our understanding of pathophysiological mechanisms that lead to CKD in this specific population. SN - 1607-8454 UR - https://www.unboundmedicine.com/medline/citation/25431929/Renal_function_in_adult_Jamaicans_with_homozygous_sickle_cell_disease_ L2 - https://www.tandfonline.com/doi/full/10.1179/1607845414Y.0000000213 DB - PRIME DP - Unbound Medicine ER -