Renal Reabsorption of Phosphate in Children with Sickle Cell Anemia

Abstract

It has previously been reported that in adult patients with sickle-cell anemia the serum phosphate value and the maximum tubular reabsorption of phosphate per liter of glomerular filtrate (TmP/GFR) were significantly higher than in normal controls. This does not appear to have been studied in children with sickle cell anemia (young sicklers) and this prompted us to assess renal phosphate reabsorption in this group of patients. We looked at serum phosphate level and calculated renal phosphate reabsorption (TP/GFR) in children taking random urine and blood samples at the same time and using the formula TP/GFR = Sp – Up × SCr: UCr, in 30 young sicklers all of whom had normal renal function (mean age 7.3 years) and 40 normal matching controls (mean age 6.5 years). The mean serum phosphate value in young sicklers was significantly lower than in controls (4.3 against 5.3 mg/dl) while the mean value of TP/GFR was 4.09 ± 0.74 mg/dl in young sicklers compared to 4.65 ± 0.75 mg/dl in the control group (p = 0.0026). Therefore, the TP/GFR in young sicklers was also significantly lower (p = 0.0026) than in the control group. This may be explained by the high serum level of parathyroid hormone reported previously in patients with sickle cell anemia which is expected to lower phosphate reabsorption (TmP/GFR and TP/GFR are identical in children). The lower serum phosphate value and TP/GFR in younger sicklers seems to be in contrast with the relatively high serum phosphate value and TP/GFR previously reported in adults with sickle cell anemia.

Evaluation of plasma Creatine Kinase activity and Inorganic phosphate among Sudanese patients with sickle cell disease in Khartoum and White Nile state

“…This finding agree with previous study conducted by Nnadi et al [25].The mean of serum phosphorus concentration showed a non-significant decrease (P = 0.547) when compared with the control group(table -2), this agree with the previous study of Al harbi et al [27], Nnadi et al [25],and this is in contrast with the study conducted by Oladipo et al [26],who reported high level in adult and children .The study showed no significant difference in mean serum Ck level in male when compared to female with (P = 0.090), also there is no significant difference in mean serum phosphorus in male when compared to female (P = The study also revealed significantly decrease in serum CK (P = 0.006) in patients used hydroxyurea when compare with the patients not used hydroxyurea. While serum phosphorus showed no significant difference (P = 0.078) between the patients used hydroxyurea and not used hydroxyurea.…”

Evaluation of Plasma Creatine Kinase Activity and Inorganic Phosphate among Sudanese Patients with Sickle Cell Disease in Khartoum and White Nile State

“…This finding agree with previous study conducted by Nnadi et al [25].The mean of serum phosphorus concentration showed a non-significant decrease (P = 0.547) when compared with the control group(table -2), this agree with the previous study of Al harbi et al [27], Nnadi et al [25],and this is in contrast with the study conducted by Oladipo et al [26],who reported high level in adult and children .The study showed no significant difference in mean serum Ck level in male when compared to female with (P = 0.090), also there is no significant difference in mean serum phosphorus in male when compared to female (P = 0.611).The study also revealed significantly decrease in serum CK (P = 0.006) in patients used hydroxyurea when compare with the patients not used hydroxyurea. While serum phosphorus showed no significant difference (P = 0.078) between the patients used hydroxyurea and not used hydroxyurea.…”

Biochemical Indicator of Sickle Cell Disease: Preliminary Report from India

“…It has previously been reported that in adult patients with sickle-cell anemia the serum phosphate value and the maximum tubular re-absorption of phosphate per liter of glomerular filtrate (TmP/GFR) significantly higher than in normal controls. The lower serum phosphate value and TP/ GFR in younger sicklers seems to be in contrast with the relatively high serum phosphate value and TP/GFR previously reported in adults with sickle cell anemia [18]. In sickle cell anemia the shortened survival of red blood cells presents the liver with an augmented load of bilirubin for hepatic clearance [19].…”