Prevalence of microalbuminuria in children with sickle cell disease
| Autor: | Pippa Simpson, Bassam Atiyeh, Vikas R. Dharnidharka, Shermine Dabbagh, Sharada A. Sarnaik |
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| Rok vydání: | 1998 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Adolescent Renal function Anemia Sickle Cell Kidney Function Tests Gastroenterology Sickle cell nephropathy Diabetic nephropathy chemistry.chemical_compound Internal medicine Prevalence medicine Albuminuria Humans Prospective Studies Child Creatinine Proteinuria business.industry medicine.disease Sickle cell anemia Cross-Sectional Studies Endocrinology chemistry Child Preschool Pediatrics Perinatology and Child Health Female Microalbuminuria medicine.symptom business |
| Zdroj: | Pediatric Nephrology. 12:475-478 |
| ISSN: | 1432-198X 0931-041X |
| DOI: | 10.1007/s004670050491 |
| Popis: | Renal involvement is common in homozygous sickle cell disease (HbSS), including glomerular hypertension and hypertrophy similar to that seen in rodent models of ablative nephrectomy and stage I diabetic nephropathy (DN). The proteinuria in the rodent models is attenuated by angiotensin converting enzyme inhibition (ACEI). Microalbuminuria (MA) is a sensitive marker for renal involvement in DN prior to the development of proteinuria, and is also attenuated with ACEI. Elevated urinary microalbumin/creatinine ratios (U Alb/Cr)20 mg/g Cr are reported in 39%-43% of adults with HbSS, and studies are ongoing in this age group to assess the effect of attenuated proteinuria by ACEI on long-term renal function. The purpose of this study was to prospectively investigate the prevalence of MA in children with HbSS and determine factors which affect its expression. U Alb/Cr values were measured on spot urine samples in 102 children (aged 2-18 years, mean 9.47+/-4.62, M:F=53:49) by rate nephelometry. Children with prior known proteinuria, hypertension, or fever/pain episode in the last 15 days were excluded. MA was present in 26.5% of all children with HbSS. However, in children between the ages of 10 and 18 years, the prevalence was 46% (similar to the prevalence in adults). There was a strong correlation between patient age and prevalence of MA (P0.0001) by both univariate and multivariate analysis. However, pain frequency, hospitalization, transfusion program, ferritin levels, and Cr clearance (C(Cr)) did not correlate with prevalence, although C(Cr) (as estimated by Schwartz formula) was elevated in all. We conclude that the prevalence of MA in the 2nd decade of life is similar to that in adults. |
| Databáze: | OpenAIRE |
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