Glomerular hyperfiltration is strongly correlated with age in Congolese children with sickle cell anaemia

Aloni, Michel Ntetani; Ngiyulu, René Makuala; Ekulu, Pépé Mfutu; Mbutiwi, Fiston Ikwa Ndol; Makulo, J.R.; Gini-Ehungu, Jean Lambert; Nseka, Nazaire Mangani; Lepira, François Bompeka

doi:10.1111/apa.13784

Cited by 11 publications

(15 citation statements)

References 26 publications

(38 reference statements)

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“…Thirty six children (35.6%) in the present study had GH, this prevalence was consistent with 33.1% [9] and 40% [14] in Congolese children, where eGFR was estimated using the same method, but lower than 76% and 72.9% reported by two different American studies [7,10]. Variation in the prevalence rate of glomerular hyper iltration between studies is not clearly understood, but it could be in luenced by inconsistency in population characteristics, the methods used to estimate or measure GFR, and the cut-offs used to de ine hyper iltration.…”

Section: Discussionsupporting

confidence: 88%

“…Current evidence provided by a longitudinal cohort study of 91 children with SCD, showed glomerular hyper iltration to precede the development of persistent albuminuria, and children with early hyper iltration are predispose to develop early microalbuminuria [13]. Microalbuminuria is another initial https://doi.org/10.29328/journal.jcn.1001065 marker of SCN tends to increase with age in parallel to decline of GFR [14], and it has been reported at a rate ranged between 11.3% -51.3% in children, and up to 68% in adults [15].…”

Section: Introductionmentioning

confidence: 99%

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Glomerular hyperfiltration in Yemeni children with sickle cell disease

M¹,

E²,

Bagherzadeh³

et al. 2021

J Clini Nephrol

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Background: Glomerular hyperfiltration (GH) is a common feature of sickle cell nephropathy (SCN) starting at infancy and represents an early marker of incipient glomerular injury and renal dysfunction. Methods: This study aimed to determine the prevalence and correlates of GH among children (≤ 16 years) with sickle cell disease (SCD) at their steady state, recruited over 6 months at the Pediatric Outpatient Clinic in Al-Sadaqa General Teaching Hospital, Aden, Yemen. Glomerular filtration rate (eGFR) was estimated using the Schwartz formula. Data on clinical history, anthropometry, blood pressure (BP) and laboratory investigations were collected. Results: Of 101 children (mean age 7.2 ± 3.9 years), 65 (64.4%) were males. The prevalence of GH was observed in 36 (35.6%) children, who were significantly older (10.7 ± 3.2 vs. 5.2 ± 2.7 years, p < 0.001) and had a lower fetal Hb level (5 ± 3.3 vs. 9 ± 7.1, p = 0.02). All children were normotensive, but hyperfiltrating children showed significantly higher systolic (97.2 ± 7.3 vs. 89.7 ± 5.2 mmHg) and diastolic pressure (55.1 ± 5.0 vs. 49 ± 4.3 mmHg) (all p < 0.001). Among evaluated children, 25.7% had hyperfiltration alone, whereas 9.9% had an associated microalbuminuria (MA), and no significant difference in eGFR between those with and without MA (158.4 ± 33.7 vs. 160.7 ± 29.8 ml/min/173m2, p = 0.84). Conclusion: This study demonstrated a relatively high prevalence of GH in Yemeni children with SCD that increased with age. Recognition of hyperfiltration and other early markers of nephropathy in this population could help to develop renal protective strategies to prevent progressive loss of kidney function.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Glomerular hyperfiltration in Yemeni children with sickle cell disease

M¹,

E²,

Bagherzadeh³

et al. 2021

J Clini Nephrol

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“…Second, our natural history data show a decline from hyperfiltration beginning around 10‐13 years of age after which time we identified no difference in eGFR between those participants with and without albuminuria. This finding may explain why several cross‐sectional studies, including our prior studies, evaluating eGFR at the time adolescent patients develop episodes of albuminuria have not identified an association of hyperfiltration and albuminuria . Finally, additional research, potentially using biomarkers of glomerular or tubular injury are needed to better understand or predict patients at risk for progression to hyperfiltration.…”

Section: Discussionmentioning

confidence: 95%

Hyperfiltration during early childhood precedes albuminuria in pediatric sickle cell nephropathy

et al. 2019

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Background In patients with diabetes mellitus, hyperfiltration precedes the development of albuminuria. Pediatric sickle cell anemia (SCA) patients have a high prevalence of hyperfiltration and albuminuria during early childhood and adolescence. We tested the hypothesis that hyperfiltration precedes the development of albuminuria in a longitudinal pediatric SCA cohort. Methods We identified 91 participants with HbSS or SB0 thalassemia 5‐21 years of age enrolled in a longitudinal sickle cell nephropathy cohort study who had a cystatin C measured during early childhood (4‐10 years of age). Early hyperfiltration was defined as a mean eGFR >180 mL/min/1.73m2 using cystatin C obtained from 4 to 10 years of age. Persistent albuminuria was defined as an albumin to creatinine ratio > 30 mg/g on two of three untimed urine specimens. Time to event analysis estimated survival curves for participants with and without hyperfiltration using Kaplan‐Meier curves and used logrank test for categorical variables to assess the association with time to development of the first episode persistent albuminuria. Results Persistent albuminuria occurred more often and at an earlier age in participants with early hyperfiltration compared to those without early hyperfiltration (log‐rank, P = .004). Participants who developed albuminuria have a significant increase in their eGFR during childhood (P = .003) as compared to participants who have not yet progressed to albuminuria (P = .26). For every 1 g/dL increase in hemoglobin, the hazard ratio for developing persistent proteinuria decreased by 0.56 (95% CI: 0.3, 1.06, P = .07). Conclusion Hyperfiltration precedes the development of persistent proteinuria in pediatric SCA patients. Intervention strategies should target lowering eGFR during early childhood.

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“…This study's finding that none of the factors examined was associated with glomerular hyperfiltration is at variance with previous studies. In the paediatric age group, the only available research on the determinants of glomerular hyperfiltration [10], reported that older age and reduced body mass index were factors associated with glomerular hyperfiltration. However, this study cannot be compared to the previous study because their definition of glomerular hyperfiltration differs.…”

Section: Discussionmentioning

confidence: 99%

“…Its aetiology in SCD is not clearly understood but, its development and progression are believed to be driven by increased glomerular perfusion and increased effective glomerular filtration surface area, but not by increased glomerular capillary hydrostatic pressure [7]. The reported prevalence of glomerular hyperfiltration in SCD, mainly in children with SCA, ranges from 40% to 98% [8] [9] [10]. These prevalence rates differ from study to study because there is no uniform definition of glomerular hyperfiltration.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Glomerular Hyperfiltration and Albuminuria in Sickle Cell Disease Adolescents: Cross-Sectional Retrospective Study

Iduoriyekemwen¹,

Booth²,

McDougall³

et al. 2021

OJNeph

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Background: Sickle Cell Disease (SCD) renal abnormalities commence early in childhood. The glomerular abnormalities, glomerular hyperfiltration and albuminuria are the most prevalent. However, these SCD glomerulopathies have not been considered exclusively in the adolescent age group. Objective: To determine the prevalence of glomerular hyperfiltration and albuminuria as well as identify the determinants for glomerular hyperfiltration in adolescents with SCD. Patients and Methods: The electronic patient records of 153 adolescents with SCD aged 10 -<19 years, attending the Paediatrics Haematology Clinic at Evelina London Children's Hospital, United Kingdom, were reviewed from the 10 th to 23 rd June 2019. Clinical information and laboratory parameters were obtained. The glomerular filtration rate was derived using the Bedside Schwartz's method. Grouping of the adolescents was based on the presence and absence of glomerular hyperfiltration, which was defined as glomerular filtration rate > 140 ml/min/m 2 . The presence of albuminuria was defined as urine albumin-to-creatinine ratio > 3 mg/mmol or protein-to-creatinine ratio of >15 mg/mmol. The clinical and laboratory determinants of glomerular hyperfiltration in the total study population were investigated. Result: Prevalence of glomerular hyperfiltration was 33.3% in the adolescents studied, and that of albuminuria was 15.7% amongst the SCD adolescents studied, of which 13.7% of those with glomerular hyperfiltration also had albuminuria. On univariable analysis, the SCD adolescents with glomerular hyperfiltration had significantly lower weight (48.0 ± 18.0 versus 54.8 ± 17.0 kg; p = 0.02), height (155.

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Glomerular hyperfiltration is strongly correlated with age in Congolese children with sickle cell anaemia

Abstract: Glomerular hyperfiltration was a common finding in this study and was significantly associated with age.

Cited by 11 publications

References 26 publications

Glomerular hyperfiltration in Yemeni children with sickle cell disease

Glomerular hyperfiltration in Yemeni children with sickle cell disease

Hyperfiltration during early childhood precedes albuminuria in pediatric sickle cell nephropathy

Evaluation of Glomerular Hyperfiltration and Albuminuria in Sickle Cell Disease Adolescents: Cross-Sectional Retrospective Study

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