Glomerular hyperfiltration and albuminuria in children with sickle cell anemia
Abstract
Early manifestations of sickle nephropathy include glomerular hyperfiltration and proteinuria, typically microalbuminuria. Over time, a subset of patients develops histologic changes, decreased glomerular filtration, and ultimately renal failure. This study was designed to determine the rate of glomerular hyperfiltration and prevalence of albuminuria in a cross-sectional analysis of untreated children with sickle cell anemia (SCA), and to identify correlates of both complications. Measured glomerular filtration rate (GFR) by plasma clearance of 99-technetium diethylenetriaminepentaacetate was compared to GFR estimates calculated from published formulas. Eighty-five children (mean age 9.4±4.8 years) were studied; 76% had glomerular hyperfiltration with mean GFR=154plusmn; 37 ml/min/1.73 m 2. GFR declined in teenage years and was significantly correlated with increased serum cystatin C levels and higher systolic blood pressure. Measured GFR had only modest correlations with GFR estimates (Pearson correlation coefficients ≤0.5). Albuminuria, usually microalbuminuria, occurred in 15.9% and was associated with higher diastolic blood pressure and lower white blood cell and absolute neutrophil counts. Cystatin C levels inversely reflect GFR changes and are associated with albuminuria; serial monitoring may provide a sensitive and accurate marker of nephropathy in children with SCA. © IPNA 2011.
Publication Title
Pediatric Nephrology
Recommended Citation
Aygun, B., Mortier, N., Smeltzer, M., Hankins, J., & Ware, R. (2011). Glomerular hyperfiltration and albuminuria in children with sickle cell anemia. Pediatric Nephrology, 26 (8), 1285-1290. https://doi.org/10.1007/s00467-011-1857-2
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