Prevalence and Progression of Chronic Kidney Disease in Adult Patients with Sickle Cell Disease

Gosmanova, Elvira O.; Zaidi, Sahar; Wan, Jim Y.; Adams-Graves, Patricia

doi:10.1097/01.jim.0000446836.75352.72

Cited by 57 publications

(60 citation statements)

References 16 publications

(31 reference statements)

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“…The endpoint of this hyperfiltration is glomerular scarring with progressive loss of renal function. Glomerular injury is evident in adults with SCD, with up to 50% of this patient group showing evidence of hyperfiltration and 21-27% having CKD, defined as an estimated glomerular filtration rate (eGFR) of <90 mL/min/ 1.73 m 2 [9][10][11][12]. The prevalence of end-stage renal disease (ESRD) in the adult SCD population has been estimated to be between 4 and 12%, with a mean time to ESRD of 37 years [12,13].…”

Section: Sickle Cell Nephropathymentioning

confidence: 99%

Acute kidney injury in children with sickle cell disease—compounding a chronic problem

2017

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In an article recently published in Pediatric Nephrology, Baddam and colleagues discuss the relatively underreported clinical problem of repeated episodes of acute kidney injury (AKI) in children with sickle cell disease (SCD). Their report is a cautionary note about the importance of repeated kidney injury on the background of underlying chronic kidney injury and its potential implications on long-term kidney outcome. In children and adults with SCD, this includes the effects of repeated vaso-occlusive crises and the management of these painful episodes with non-steroidal anti-inflammatory drugs. Here we review the scope of kidney involvement in SCD in children and discuss the potential short-and long-term consequences of AKI in children with SCD.

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Section: Sickle Cell Nephropathymentioning

confidence: 99%

Acute kidney injury in children with sickle cell disease—compounding a chronic problem

2017

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“…While it is clear that many young adult patients with SCA develop a decline in their eGFR and progress to CKD, current studies fail to identify consistent risk factors and interventions that modify disease progression [13, 14]. Nocturnal hypertension and hyperuricemia are well-established, independent risk factors for cardiovascular disease and progression to CKD in children without SCA [15-19].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, we evaluated other clinical and laboratory variables that prior studies suggest may be associated with a lower eGFR [5, 8, 13, 14, 26-28]. …”

Section: Introductionmentioning

confidence: 99%

Evaluating risk factors for chronic kidney disease in pediatric patients with sickle cell anemia

et al. 2017

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Background Patients with Sickle Cell Anemia (SCA) have an increased prevalence of nephropathy and mortality from chronic kidney disease (CKD). Methods We evaluated the association of hyperuricemia and nocturnal hypertension with lower estimated glomerular filtration rate (eGFR) by cystatin-C among patients 10-21 years old with HbSS or SB0 thalassemia during a non-acute clinic visit. eGFR was obtained in 83 participants, uric acid in 81, and 24 hour ambulatory blood pressure monitoring (ABPM) was performed in 44 participants. Vital signs, CBC, CMP, LDH, medications, and urine microalbumin/creatinine were measured. Hyperuricemia was defined as a uric acid level ≥5.5 mg/dL. Nocturnal hypertension was defined as >25 % of nocturnal readings >95th percentile according to norms established by the American Heart Association Statement on ABPM in children and adolescents. Results The mean eGFR was statistically significantly lower among patients with hyperuricemia than with normal uric acid levels (143 vs 161 mL/min/1.73m2, respectively). Fourteen of 44 (32 %) participants had systolic nocturnal hypertension and 12 of 44 (27 %) had diastolic nocturnal hypertension. The mean eGFR was statistically significantly lower among participants with nocturnal systolic and diastolic hypertension than normal nocturnal blood pressure. In a regression model, nocturnal hypertension and hyperuricemia were associated with a lower eGFR. Conclusion Two risk factors for CKD, nocturnal hypertension and hyperuricemia, were associated with lower eGFR in older children and adolescent patients with SCA, and warrant long-term studies of their association with progression to CKD in this population.

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“…Albuminuria > 500 mg/g and nephrotic syndrome have been associated with progression to end-stage renal disease (ESRD) in adulthood in more than one study [58,59].…”

Section: Hematuriamentioning

confidence: 99%

Sickle Cell Nephropathy in the Pediatric Population

et al. 2018

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Background: Compared to the past, patients with sickle cell disease (SCD) currently live longer due to improvements in diagnosis and comprehensive care. Due to these advances, long-term chronic complications pose a greater challenge in the management of patients with SCD. In particular, sickle cell nephropathy (SCN) is associated with significant morbidity and mortality across all age groups. Furthermore, SCN is an understudied condition with relatively few symptoms and therefore requires close surveillance. In this review, we sought to explore the epidemiology, natural history, and treatment options for SCN with an emphasis on the pediatric population. Summary: SCN invariably begins in childhood with evidence of structural changes detected as early as infancy. These indolent changes can progress undetected to advanced chronic kidney disease by late adolescence or early adulthood. The risk factors for progression are not well defined, but significant albuminuria (which is also the most common presentation in childhood) is a key factor in progression. One of the main challenges in understanding SCN in children is the poor correlation between estimated and measured glomerular filtration rates. Another challenge is the lack of large-scale longitudinal studies that track the clinical outcomes of pediatric patients over time. Several studies aim to identify early biomarkers of SCN in children, as albuminuria presents only following significant chronic damage. The utility of angiotensin converting enzyme inhibitors and hydroxyurea in treating albuminuria is addressed here as well as novel treatments that may be of benefit.

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Prevalence and Progression of Chronic Kidney Disease in Adult Patients with Sickle Cell Disease

Cited by 57 publications

References 16 publications

Acute kidney injury in children with sickle cell disease—compounding a chronic problem

Acute kidney injury in children with sickle cell disease—compounding a chronic problem

Evaluating risk factors for chronic kidney disease in pediatric patients with sickle cell anemia

Sickle Cell Nephropathy in the Pediatric Population

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