Relevance of repeated analyses of albuminuria and glomerular filtration rate in African children with sickle cell anaemia.

Autor: Nkoy AB; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.; Laboratory of Pediatric Nephrology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium., Mumaka FM; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo., Ngonde A; REZODREPANO SS, Kinshasa, Democratic Republic of Congo., Mafumba SK; Hôpital Général de Référence de Kinkole, Kinshasa, Democratic Republic of Congo., Matoka TT; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo., Kitenge R; Centre de Formation et d'Appui Sanitaire (CEFA)/Monkole, Kinshasa, Democratic Republic of Congo., Talu FM; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo., Nkolomoni B; Centre de Médecine Mixte et Anémie SS (CMMASS), Kinshasa, Democratic Republic of Congo., Tshilolo L; Centre de Formation et d'Appui Sanitaire (CEFA)/Monkole, Kinshasa, Democratic Republic of Congo., van den Heuvel LP; Laboratory of Pediatric Nephrology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.; Department of Pediatric Nephrology, Radboud University Medical Centre, Nijmegen, The Netherlands., Ekulu PM; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo., Levtchenko EN; Laboratory of Pediatric Nephrology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.; Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam University Medical Centre, Amsterdam, The Netherlands., Labarque V; Department of Pediatric Hematology, University Hospital Leuven, Leuven, Belgium.; Department of Cardiovascular Sciences, Center for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2024 Sep; Vol. 205 (3), pp. 1137-1146. Date of Electronic Publication: 2024 Jun 27.
DOI: 10.1111/bjh.19603
Abstrakt: Glomerular hyperfiltration and albuminuria are frequent kidney abnormalities in children with sickle cell anaemia (SCA). However, little is known about their persistence in African SCA children. This prospective study included 600 steady-state SCA children aged 2-18 years from the Democratic Republic of Congo. Participants were genotyped for apolipoprotein L1 (APOL1) risk variants (RVs) and haem oxygenase-1 (HMOX1) GT-dinucleotide repeats. Kidney abnormalities were defined as albuminuria, hyperfiltration or decreased estimated creatinine-based glomerular filtration rate (eGFRcr). At baseline, 247/600 (41.2%) participants presented with kidney abnormalities: 82/592 (13.8%) with albuminuria, 184/587 (31.3%) with hyperfiltration and 15/587 (2.6%) with decreased eGFRcr. After a median follow-up of 5 months, repeated testing was performed in 180/247 (72.9%) available participants. Persistent hyperfiltration and persistent albuminuria (PA) were present in 29.2% (38/130) and 39.7% (23/58) respectively. eGFR normalized in all participants with a baseline decreased eGFRcr. Haemoglobinuria (p = 0.017) and male gender (p = 0.047) were significantly associated with PA and persistent hyperfiltration respectively. APOL1 RVs (G1G1/G2G2/G1G2) were borderline associated with PA (p = 0.075), while HMOX1 long repeat was not associated with any persistent kidney abnormality. This study reveals that a single screening can overestimate the rate of kidney abnormalities in children with SCA and could lead to overtreatment.
(© 2024 British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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