Prevalence and clinical correlates of microalbuminuria in children with sickle cell disease

Becton, Lauren J.; Kalpatthi, Ram; Rackoff, Elizabeth; Disco, Deborah; Orak, John K.; Jackson, Sherron M.; Shatat, Ibrahim F.

doi:10.1007/s00467-010-1536-8

Cited by 78 publications

(74 citation statements)

References 24 publications

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“…In children with SCA, significant associations have been found between proteinuria and the hemolysis markers of low hemoglobin (Hb) and high lactate dehydrogenase (LDH). 5,13 Similar studies in adults, however, have not replicated this finding, although an association between low hemoglobin levels and hyperfiltration have been reported. [14][15] More recently, Maier-Redelsperger et al utilized a marker of red cell survival derived from mature red blood cell hemoglobin (RBC Hb) and reticulocyte hemoglobin (RET Hb), and showed that the log (RBC Hb/RET Hb) was highly correlated with LDH, bilirubin and albuminuria.…”

Section: Introductionmentioning

confidence: 90%

“…4 It is thought that chronic ischemia secondary to repeated vasoocclusive events in the microvasculature of the renal medulla results in a prostaglandin-induced increase in total renal plasma flow leading to the raised glomerular filtration rate (GFR) seen in childhood and early adulthood. [4][5] Prolonged hyperfiltration eventually leads to glomerular sclerosis and the GFR decreases towards normal as the patient ages. 4 In some, this decline is accelerated and continuous resulting in end-stage renal failure.…”

Section: Introductionmentioning

confidence: 99%

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Association between hemolysis and albuminuria in adults with sickle cell anemia

Day

Drašar²,

Fulford³

et al. 2011

Haematologica

104

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We have investigated renal function and markers of hemolysis in a cohort of 424 adult African-British patients with sickle cell disease. While significant associations were found in HbSS and HbSb 0 (sickle cell anemia) patients with and without controlling for covariates between hemolytic markers and albuminuria, the associations were not significant in patients with HbSC. Estimated glomerular filtration rate, a marker of renal function, correlated significantly with reticulocyte count and bilirubin. Alpha thalassemia, present in 34% of the sickle cell anaemia patients, had a protective effect against albuminuria in this group. Altogether, the incidence of hyperfiltration was 71% and microalbuminuria 37%, making nephropathy a common complication of sickle cell anemia. Haematologica 2012;97(2):201-205. doi:10.3324/haematol.2011 This is an open-access paper. ABSTRACTexcluded from the study group if they had a history of diabetes mellitus, HIV infection, malignancy or another cause of chronic kidney disease (CKD) or if they were on a blood transfusion program. Seventeen patients were on ACE (angiotensin converting enzyme) inhibitor or ARB (angiotensin II receptor blocker) therapy; these patients were also excluded from the study. Since 2006, urinary albumin/creatinine ratio (ACR) has been a routine measurement for patients attending the specialist clinic. All patients were routinely genotyped for α thalassemia using a PCR-based methodology on DNA extracted from peripheral blood.17

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Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Association between hemolysis and albuminuria in adults with sickle cell anemia

Day

Drašar²,

Fulford³

et al. 2011

Haematologica

104

View full text Add to dashboard Cite

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“…Macroalbuminuria is a sensitive primary indicator of glomerulopathy, preceding the development of progressive renal insufficiency (Guasch et al, 1999) and ultimately leading to end-stage renal disease (ESRD) in both children and adults (Becton et al, 2010;Guasch et al, 1999Guasch et al, , 2006. Focal segmental glomerulosclerosis (FSGS) and collapsing glomerulosclerosis are subtypes of podocytopathies and podocyte injury, which is proposed to play a key role in the development and progression of kidney disease (Barisoni and Nelson, 2007).…”

Section: Sickle Cell and Cardiovascular Disease Genetics 583mentioning

confidence: 99%

Genetics of Sickle Cell-Associated Cardiovascular Disease: An Expert Review with Lessons Learned in Africa

Geard

Pule

Chelo

et al. 2016

OMICS: A Journal of Integrative Biology

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Sickle cell disease (SCD) vastly impacts the African continent and is associated with cardiovascular diseases. Stroke, kidney disease, and pulmonary hypertension are considered as proxies of severity in SCD with several genomic loci implicated in their heritability. The present expert review examined the current data on epidemiology and genetic risk factors of stroke, pulmonary hypertension, and kidney disease associated with SCD, as indexed in PubMed Ò and Google Scholar Ò . Studies collectively show that stroke and kidney disease each affect *10% of SCD patients, with pulmonary hypertension displaying a higher prevalence of 30% among adults with SCD. There is some evidence that these epidemiology figures may be an underestimate in SCD patients living in Africa. A modest number of publications have identified genetic factors involved in pathways regulating inflammation, coagulation, cell adhesion, heme degradation, a-globin and c-globin production, and others, which contribute to the development risk of targeted cardiovascular phenotypes. However, in most cases, these studies have not been validated across populations. There is therefore an urgent need for large-scale genome-wide association, wholeexome and whole-genome studies, and multiomics research on cardiovascular diseases associated with SCD, particularly in Africa, to allow for proportional investment of global research funding on diseases that greatly impact the African continent. Ultimately, this will cultivate socially responsible research investments and identification of at-risk individuals with improved preventive medicine, which should be a cornerstone of global precision medicine.

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“…Microalbuminuria has also been investigated in numerous nephrologic and other diseases, such as microhaematuria [56], sickle cell anemia [30,57], low-birth weight [58], congenital solitary kidneys [59], orthostatic proteinuria [34], metabolic syndrome [28].…”

Section: Microalbuminuria In Different Childhood Diseasesmentioning

confidence: 99%

“…Unfortunately, there are no studies yet, investigating the role of microalbuminuria in children as cardiovascular risk factor later in adult life, which is important future task. Anyway, the clinical significance of microalbuminuria in diabetic children has been confirmed [25,26] as well as in some other diseases in children [27][28][29][30]. Some small intervention studies have also been conducted, suggesting that early intervention with medications is likely to be beneficial in children too [31,32].…”

Section: Introductionmentioning

confidence: 99%

Microalbuminuria in pediatric patients with hypertension

Varda¹

2013

Health

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Microalbuminuria in adults has been found to be an early indicator of both renal and systemic vascular disease, as well as significant cardiovascular risk predictor and therapeutic marker. Its role in essential hypertension in adults has also been well established. As diseases like hypertension and obesity have their roots in childhood and are already present in children, influencing the morbidity in adulthood, the role of microalbuminuria has been extensively investigated in children as well. Most investigations have been performed in diabetic children, confirming its clinical significance. There is also enough evidence to suggest that microalbuminuria in obese children should be taken as seriously as in children with diabetes. In children with hypertension rare studies also indicate that its presence identifies hypertensive children with higher risk, although the exact role has to be confirmed in prospective and larger studies. The mechanisms of microalbuminuria onset could be the result of renal damage secondary to hypertension or underlying renal and systemic endothelial dysfunction. Evidence from small intervention studies in children with microalbuminuria also suggests that early intervention with antihypertensive drugs is likely to be beneficial, pointing out the role of microalbuminuria as a therapeutic marker in children too. In addition, we have to stress the importance of follow-up of children with microalbuminuria, confirmation of its persistence and identification of progression. However, longitudinal prospective studies in children, investigating its future cardiovascular risk, are still lacking.

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Prevalence and clinical correlates of microalbuminuria in children with sickle cell disease

Cited by 78 publications

References 24 publications

Association between hemolysis and albuminuria in adults with sickle cell anemia

Association between hemolysis and albuminuria in adults with sickle cell anemia

Genetics of Sickle Cell-Associated Cardiovascular Disease: An Expert Review with Lessons Learned in Africa

Microalbuminuria in pediatric patients with hypertension

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