Lactate dehydrogenase as a biomarker for early renal damage in patients with sickle cell disease

Abstract

Among many complications of sickle cell disease, renal failure is the main contributor to early mortality. It is present in up to 21% of patients with sickle cell disease. Although screening for microalbuminuria and proteinuria is the current acceptable practice to detect and follow renal damage in patients with sickle cell disease, there is a crucial need for other, more sensitive biomarkers. This becomes especially true knowing that those biomarkers start to appear only after more than 60% of the kidney function is lost. The primary purpose of this study is to determine whether lactate dehydrogenase (LDH) correlates with other, direct and indirect bio-markers of renal insufficiency in patients with sickle cell disease and, therefore, could be used as a biomarker for early renal damage in patients with sickle cell disease. Fifty-five patients with an established diagnosis of sickle cell disease were recruited to in the study. Blood samples were taken and 24-h urine collection samples were collected. Using Statcrunch, a data analysis tool available on the web, we studied the correlation between LDH and other biomarkers of kidney function as well as the distribution and relationship between the variables. Regression analysis showed a significant negative correlation between serum LDH and creatinine clearance, R (correlation coefficient) = -0.44, P = 0.0008. This correlation was more significant at younger age. This study shows that in sickle cell patients LDH correlates with creatinine clearance and, therefore, LDH could serve as a biomarker to predict renal insufficiency in those patients.

Technology Transfer of the Microphysiological Systems: A Case Study of the Human Proximal Tubule Tissue Chip

“…Similarly to the studies with polymyxin B, KIM-1 concentration in the cell culture media or effluent was not indicative of the toxicity as the levels of KIM-1 decreased as cell death increased over time. LDH concentration, on the other hand, was significantly increased relative to controls in many of the treatments prior to falling off along with cell viability, indicating that it may be a more suitable biomarker for in vitro nephrotoxicity studies 59 .…”

A decision support system for the prediction of mortality in patients with acute kidney injury admitted in intensive care unit

“…Our study showed that LDH levels on the day 7 were associated with late mortality in AKI. Alzahri et al (2015) and Zager et al (2013) have demonstrated the relationship between LDH and kidney damage. Our study found that LDH can also be used in the prediction of mortality in patients with AKI.…”

Albuminuria, serum antioxidant enzyme levels and markers of hemolysis and inflammation in steady state children with sickle cell anemia

“…The positive association between albuminuria and LDH suggest the central role of hemolysis as the starting point for many of the subsequent complications of SCA, including kidney damage [14, 18]. A Previous study has already reported a significant correlation between serum LDH levels and albuminuria [19]. Indeed, hemolysis through increased plasma-free hemoglobin concentrations can induce the generation of ROS by non-enzymatic (Fenton reaction) with subsequent oxidative stress, inflammation, endothelial dysfunction and tissue damage [14, 19].…”

“…A Previous study has already reported a significant correlation between serum LDH levels and albuminuria [19]. Indeed, hemolysis through increased plasma-free hemoglobin concentrations can induce the generation of ROS by non-enzymatic (Fenton reaction) with subsequent oxidative stress, inflammation, endothelial dysfunction and tissue damage [14, 19]. However, the hemolytic origin of circulating LDH remains a matter of controversy.…”