Risk Factors for Microalbuminuria in Children With Sickle Cell Anemia

McBurney, Patricia G.; Hanevold, Coral; Hernandez, Caterina M.; Waller, Jennifer L.; McKie, Kathleen T.

doi:10.1097/00043426-200208000-00013

Cited by 55 publications

(76 citation statements)

References 12 publications

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“…In this study, we showed the prevalence of MA to be 16%, which is consistent with what has been previously reported by other authors [11][12][13][14][15][16][17]. To the best of our knowledge, this is the first study to specifically examine the relationship between blood pressure classification and microalbuminuria in children with sickle cell disease.…”

Section: Discussionsupporting

confidence: 92%

“…Proteinuria, hypertension, and severe anemia have been shown to be predictors of ESRD in sickle cell nephropathy [1]. Studies in pediatric sickle cell patients have found the prevalence of abnormal urinary protein excretion to be as high as 28% (Table 4) [11][12][13][14][15][16][17]. In the largest of these studies, McKie et al studied 191 patients with Hb SS disease [12].…”

Section: Discussionmentioning

confidence: 99%

“…In fact, the prevalence of MA or proteinuria in children with SCD has been shown to range from 18 to 28%. Although it can be intermittent in an individual, there still seems to be a correlation between MA and increasing age and decreasing hemoglobin (Hb) levels in children and adolescents with SCD [11][12][13][14][15][16][17]. Acute chest syndrome (ACS) has also been suggested to be positively correlated with MA, although reports of this association are inconsistent in the literature [17].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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Sickle cell disease (SCD) is associated with a large spectrum of renal abnormalities, one of which, microalbuminuria/proteinuria (MA/P), is a known predictor of end-stage renal disease. We studied 90 children with SCD (57% male; mean age 11.4 +/- 5.2 years) to determine the prevalence and examine clinical correlates of MA/P. The average of two spot urine microalbumin-to-creatinine samples obtained 6 months apart was recorded. Medical records were reviewed for demographic and biochemical data. Medication use, resting office blood pressures (BP), vaso-occlusive pain crises (VOC), and monthly transfusions were recorded. Fourteen children (15.5%) had MA/P. Hemoglobin (Hb) levels were significantly lower in the children with MA than in those without MA/P (8.8 +/- 1.1 vs. 9.8 +/- 1.4 g/dL, respectively) and were significantly correlated with MA (rho = 0.24, p = 0.03). Children with MA were more likely to have abnormal BP (p = 0.058), with 5/14 being hypertensive or pre-hypertensive. In a multivariate logistic regression model of MA, both Hb and BP classification remained in the final model. MA is a simple screening biomarker of early kidney injury in children with SCD. Larger studies to evaluate predictive factors of MA and the relationship to BP are needed.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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“…This is similar to the findings reported by Unuigbe et al 26 in Benin City, Jones el al 15 in the USA and by Marsenic et al 29 and McBurney at al 30 among childern with sickle cell amaenia in the USA. They reported a positive correlation between microalbuminuria and age.…”

Section: Discussionsupporting

confidence: 90%

Prevalence of Microalbuminuria among secondary school children

Okpere

Anochie²,

Eke³

2012

Af Hlth Sci

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Background: Microalbuminuria is an early sign of kidney and cardiovascular damage. Therefore, early detection in asymptomatic individuals may be helpful in preventing deterioration in renal function. Methods: We carried out a cross-sectional study of 820 secondary school students aged 10 -19 years from September to November 2008. The urine samples of 615 (75.0%) without overt proteinuria and haematuria were tested for microalbuminuria using the micral test strips. Values of greater than 20mg/L were considered positive. Results: There were 299 (48.6%) males and 316 (51.4%) females, with a M:F ratio of 1:1.1. The prevalence of microalbuminuria as seen in 214 of the students was 33.2%. It was significantly higher in females (45.3%), obese subjects (35.4%), those with hypertension (70.6%), those with positive family history of hypertension (59.5%), and diabetes mellitus (46.4%). Microalbuminuria was found in 1 of the 2 subjects who had features of DM and in one subject with sickle cell anemia. Conclusion:The prevalence of microalbuminuria in Nigerian adolescents is high. We recommend routine screening for microalbuminuria in adolescents for early detection and prevention of renal damage.

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“…This causes medullary capillary congestion with extravasation of RBCs into the tubular lumen or rupture of the submucosal capillaries of the renal pelvis [1,50]. Macroscopic hematuria is a potentially life-threatening complication that may occur from renal papillary ne- Albuminuria Several studies have suggested that 16-27% of children with SCD have albuminuria [14,44,53,54].…”

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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Risk Factors for Microalbuminuria in Children With Sickle Cell Anemia

Abstract: Microalbuminuria is strongly and directly related to age and strongly and inversely related to hemoglobin levels. Identification of risk factors for microalbuminuria may allow earlier intervention to prevent renal complications in patients with sickle cell disease.

Cited by 55 publications

References 12 publications

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

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

Prevalence of Microalbuminuria among secondary school children

Sickle Cell Nephropathy in the Pediatric Population

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