Caracterización de las complicaciones renales en pacientes con anemia de células falciformes

Isaza-López, M C; Rosas, Luisa Fernanda Rojas; Echavarría-Ospina, L; Serna-­Higuita, Lina María

doi:10.32641/rchped.v91i1.1274

Cited by 5 publications

(2 citation statements)

References 21 publications

(35 reference statements)

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“…Es necesario mejorar la sospecha, diagnóstico y manejo de los pacientes con ECF en Chile, para lo cual se hace necesario organizar un registro de pacientes con ECF y coordinar las unidades que atienden este tipo de pacientes a nivel nacional. Además, la vasta experiencia de otros países de Latinoamérica en investigación 13,23 , estudio 24,25 , manejo 26,27 y educación del personal de salud en ECF 28 , debe motivar la colaboración internacional.…”

Section: Discussionunclassified

Enfermedad de células falciformes en una unidad de referencia de hematología pediátrica

Quezada

G.²,

F³

et al. 2022

Andes pediatr

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La enfermedad de células falciformes (ECF) es una hemoglobinopatía de herencia autosómica recesiva. La prevalencia de ECF puede cambiar especialmente por fenómenos migratorios. Objetivo: Describir las características de pacientes con ECF, al diagnóstico, en un hospital de referencia a lo largo de una década. Pacientes y Método: Estudio retrospectivo de las características clínicas y de laboratorio de menores de 15 años con ECF, diagnosticados en el Servicio de Onco-Hematología del Hospital Dr. Roberto del Rio, Santiago de Chile, entre abril 2008 y marzo 2018. Se evaluó sexo, edad, nacionalidad, síntomas, características del hemograma y resultados de electroforesis de hemoglobina. Los datos se analizaron mediante análisis estadístico descriptivo. Resultados: Dieciséis pacientes fueron diagnosticados de ECF, 2 eran portadoras sanas y se excluyeron. De los 14 analizados, 2 se diagnosticaron antes del 2015. Doce eran varones, 9 eran chilenos y 13 tenían progenitores extranjeros. Ocho tenían menos de 2 años y 12 fueron sintomáticos. Los síntomas más frecuentes fueron dolor de extremidades y anemia. La mediana de hemoglobina fue 8,2 g/dL (6,2-12,3). Se observaron drepanocitos en 11 de 14 pacientes, en 4 mediante test de metabisulfito. En 13/14, se realizó electroforesis de hemoglobina: mediana de hemoglobina S 70,2% (28,2-87,1) y de hemoglobina F 18,7% (0-32,3). Un paciente tenía estudio genético. Trece pacientes continuaban en control, 84,6% recibían ácido fólico y amoxicilina, 53,8% requerían transfusiones y 69,2% habían iniciado hidroxiurea. Conclusión: La ECF ha aumentado en Chile; por ende se debe tener un alto grado de sospecha y mejorar localmente su diagnóstico, tratamiento y seguimiento.

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Section: Discussionunclassified

Enfermedad de células falciformes en una unidad de referencia de hematología pediátrica

Quezada

G.²,

F³

et al. 2022

Andes pediatr

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“…For example, chronic kidney failure, in a vicious cycle, can lead to progressive myocardial and vascular damages. Further, cardiopulmonary complications in individuals with SCD may be related to the presence of nephropathies [ 6 ]. The understanding of the proportion of the SCD population that has both of these complications is limited.…”

Section: Introductionmentioning

confidence: 99%

Acute care utilization among individuals with sickle cell disease and related cardiopulmonary and renal complications

Singh,

Brousseau,

Dasgupta

et al. 2024

PLoS ONE

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Cardiopulmonary and renal end organ (CPR) complications are associated with early mortality among individuals with sickle cell disease (SCD). However, there is limited knowledge regarding acute care utilization for individuals with SCD and CPR complications. Our objective was to determine the prevalence of CPR complications in a state specific SCD population and compare acute care utilization among individuals with and without CPR complications. We leveraged 2017–2020 data for individuals with SCD identified by the Sickle Cell Data Collection program in Wisconsin. The prevalence of CPR complications is determined for distinct age groups. Generalized linear models adjusted for age compared the rate of acute care visits/person/year among individuals who had cardiopulmonary only, renal only, both cardiopulmonary and renal, or no CPR complications. There were 1378 individuals with SCD, 52% females, mean (SD) age 28.3 (18.5) years; 48% had at least one CPR complication during the study period. The prevalence of CPR complications was higher in adults (69%) compared to pediatric (15%) and transition (51%) groups. Individuals with SCD and cardiopulmonary complications had higher acute visit rates than those without CPR complications (5.4 (IQR 5.0–5.8) vs 2.4 (IQR 2.1–2.5), p <0.001)). Acute care visit rates were similar between individuals with SCD who had renal only complications and no CPR complications (2.7 (IQR 2.5–3.0) vs 2.4 (2.1–2.5), p = 0.24). The high acute care visit rates, especially for those with cardiopulmonary complications, warrant further investigation to understand risk factors for CPR complications, the underlying reasons and identify effective disease management strategies.

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The Risk of Kidney Injury in Patients With Sickle Cell Disease Treated With Ketorolac for Acute Pain

Harris,

Oni,

Donado

et al. 2024

Journal of Pediatric Hematology/Oncology

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Ketorolac, a nonsteroidal anti-inflammatory drug, is used in combination with opioids to manage vaso-occlusive episodes (VOEs). The relationship between ketorolac use and kidney injury in pediatric patients with sickle cell disease (SCD) remains incompletely understood. We hypothesize that ketorolac is associated with acute kidney injury (AKI) in patients with SCD presenting with pain. All nonsurgical hospitalizations for VOEs treated with ketorolac between January 2014 and December 2022 were included. We used optimal matching methodology to identify control admissions (2:1 ratio) and used nonparametric tests to compare ketorolac administration between cases and controls. A total of 1319 encounters/253 patients were included in this study. AKI was noted in 1.1% of encounters and 5.5% of patients. Cases had significantly higher initial BUN than controls (9.0 vs. 6.0 mg/dL, P=0.012). In cases versus controls, there was significantly lower serum sodium (136.0 vs. 138.0 mmol/L, P=0.021). There was no association between ketorolac dose and development of AKI among children with SCD. Higher BUN and lower sodium in cases suggest that patients with AKI were more volume depleted on admission than controls. This highlights the need for strict assessment of fluid status upon admission for VOE.

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Caracterización de las complicaciones renales en pacientes con anemia de células falciformes

Cited by 5 publications

References 21 publications

Enfermedad de células falciformes en una unidad de referencia de hematología pediátrica

Enfermedad de células falciformes en una unidad de referencia de hematología pediátrica

Acute care utilization among individuals with sickle cell disease and related cardiopulmonary and renal complications

The Risk of Kidney Injury in Patients With Sickle Cell Disease Treated With Ketorolac for Acute Pain

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