Proteinuria among adult sickle cell anemia patients in Nigeria

Abdu, Aliyu; Emokpae, Mathias Abiodun; Uadia, Patrick; Kuliya‐Gwarzo, Aisha

doi:10.4103/1596-3519.76578

Cited by 25 publications

(23 citation statements)

References 14 publications

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“…Twenty percent of the HbSS cohort had proteinuria, which is similar to the 22.3% reported by Iwalokun et al [21] and the 28% reported by Abdu et al [22]. To the contrary, Bolarinwa et al [23] reported a higher prevalence of proteinuria (50%) in their HbSS cohort; a probable explanation for this high level of proteinuria could be the inclusion of individuals with both microalbuminuria and macroalbuminuria in their study.…”

Section: Discussionsupporting

confidence: 81%

“…Stage 3 has been reported to represent a critical point in the spectrum of CKD, as it marks the beginning of established kidney disease according to the K/DOQI classification [15]. An earlier report by Abdu et al [22] from Kano, north central Nigeria, noted that as much as 50% of SCD patients with proteinuria had CKD. This finding further underscores the importance of proteinuria in the assessment of renal status in SCD.…”

Section: Discussionmentioning

confidence: 99%

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Degrees of Kidney Disease in Nigerian Adults with Sickle-Cell Disease

Aneke

Adegoke²,

Oyekunle³

et al. 2014

Med Princ Pract

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Objective: To study degrees of chronic kidney disease (CKD) using creatinine clearance in adult Nigerian patients with sickle-cell disease (SCD). Methods: One hundred SCD patients, made up of 79 HbSS (homozygous haemoglobin S) patients and 21 HbSC (heterozygous haemoglobins S and C) patients, were investigated prospectively, along with 50 normal controls. Their sociodemographic data, weight and drug history were documented. Each participant underwent dipstick urinalysis, and creatinine clearance was calculated following a 24-hour urine collection and serum creatinine measurement. They were categorized into stages of CKD based on the creatinine clearance. Results: Of the 79 HbSS patients, 14 (18%), 28 (35%), 33 (42%) and 4 (5%) had stage 1, 2, 3 and 4 CKD, respectively. In the HbSC group, 3 (14%), 9 (43%) and 9 (43%) patients had stage 1, 2 and 3 CKD, respectively. Proteinuria was noted in 16 (20%) HbSS patients but not in any of the HbSC patients. Of the subjects aged ≤24 years (n = 49), 9 (18%), 18 (37%), 21 (43%) and 1 (2%) had stage 1, 2, 3 and 4 CKD, respectively. Of those aged >24 years (n = 51), 8 (16%), 19 (37%), 21 (41%) and 3 (6%) had stage 1, 2, 3 and 4 CKD, respectively. None of the subjects had stage 5 CKD. Conclusion: In this study, the adult subjects with SCD had various degrees of CKD. Adequate follow-up and active intervention are advocated to delay the onset of end-stage nephropathy.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Degrees of Kidney Disease in Nigerian Adults with Sickle-Cell Disease

Aneke

Adegoke²,

Oyekunle³

et al. 2014

Med Princ Pract

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“…In the present study significant microalbuminuria, which is an early predictor of glomerular lesion, was observed in 27% of cases, which is lower than the described in previous studies [18,19,20,21,22,23,24]. This difference could be attributable to differences in genetics, includuing different haplotypes.…”

Section: Discussioncontrasting

confidence: 55%

Renal Tubular Dysfunction in Sickle Cell Disease

Silva

Vieira

Couto

et al. 2013

Kidney Blood Press Res

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Background/Aims: Kidney abnormalities are one of the main chronic complications of sickle cell disease (SCD). The aim of this study is to investigate the occurrence of renal tubular abnormalities among patients with SCD. Methods: This is a prospective study with 26 SCD adult patients in Brazil. Urinary acidification and concentration tests were performed using calcium chloride (CaCl₂), after a 12h period of water and food deprivation. Fractional excretion of sodium (FE_Na), transtubular potassium gradient (TTKG) and solute free water reabsorption (TcH₂O) were calculated. The SCD group was compared to a group of 15 healthy volunteers (control group). Results: Patient`s average age and gender were similar to controls. Urinary acidification deficit was found in 10 SCD patients (38.4%), who presented urinary pH >5.3 after CaCl₂ test. Urinary osmolality was significantly lower in SCD patients (355±60 vs. 818±202mOsm/kg, p=0.0001, after 12h period water deprivation). Urinary concentration deficit was found in all SCD patients (100%). FE_Na was higher among SCD patients (0.75±0.3 vs. 0.55±0.2%, p=0.02). The TTKG was higher in SCD patients (5.5±2.5 vs. 3.0±1.5, p=0.001), and TcH₂O was lower (0.22±0.3 vs. 1.1±0.3L/day, p=0.0001). Conclusions: SCD is associated with important kidney dysfunction. The main abnormalities found were urinary concentrating and incomplete distal acidification defect. There was also an increase in the potassium transport and decrease in water reabsorption, evidencing the occurrence of distal tubular dysfunction.

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“…A Previous study reported the relationship between albuminuria and inflammation, and hemolysis [17]. This report has been confirmed by our results, albuminuria was positively correlated with leukocytes count and LDH level.…”

Section: Discussionsupporting

confidence: 91%

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

et al. 2016

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BackgroundOxidative stress is thought to be involved in the pathogenesis of microalbuminuria in Sickle cell anemia (SCA). Antioxidant enzymes such as glutathione peroxidase (GPx) and Cu-Zn superoxide dismutase (SOD) may play an important protective role. This study aimed to evaluate the association between albuminuria and these two antioxidant enzymes.MethodsWe consecutively recruited Steady state children aged between 2 and 18 years old with established diagnosis of homozygous SCA in two hospitals of Kinshasa/DR Congo. The relationship between Urinary Albumin Creatinine Ratio (UACR) and other variables of interest (age, systolic blood pressure, diastolic blood pressure, plasma GPx and Cu-Zn SOD, free plasmatic hemoglobin, LDH, indirect bilirubin, white blood cells (WBC), percentage of fetal hemoglobin, serum iron, ferritin, CRP) was analyzed by Bivariate correlation (Pearson’s correlation coefficient). Microalbuminuria was defined by urine albumin/creatinine ratio between 30 and 299 mg/g.ResultsSeventy Steady state Black African children with SCA (56% boys; average age 9.9 ± 4.3 years; 53% receiving hydroxyurea) were selected. Prevalence of microalbuminuria was 11.8%. LDH (r = 0.260; p = 0.033) and WBC count (r = 0.264; p = 0.033) were positively correlated with UACR whereas GPx (− 0.328; p = 0.007) and Cu-Zn SOD (− 0.210; p = 0.091) were negatively correlated with UACR.ConclusionsAlbuminuria is associated with decreased antioxidant capacity and increased levels of markers of hemolysis and inflammation. Therefore, strategies targeting the reduction of sickling and subsequent hemolysis, oxidative stress and inflammation could help preventing or at least delaying the progression of kidney disease in SCA children.

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Proteinuria among adult sickle cell anemia patients in Nigeria

Abstract: Proteinuria which is a marker of renal insufficiency is common among adult SCA patients, and routine screening for proteinuria may help detect those at increased risk of renal disease. CKD prevalence is high among SCA patients with significant proteinuria.

Cited by 25 publications

References 14 publications

Degrees of Kidney Disease in Nigerian Adults with Sickle-Cell Disease

Degrees of Kidney Disease in Nigerian Adults with Sickle-Cell Disease

Renal Tubular Dysfunction in Sickle Cell Disease

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

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