Glomerular hyperfiltration and albuminuria in children with sickle cell anemia
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Banu Aygun & Nicole A. Mortier & Matthew P. Smeltzer & Jane S. Hankins & Russell E. Ware
- چاپ و سال / کشور: 2011
Description
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 9.4پ}4.8 years) were studied; 76% had glomerular hyperfiltration with mean GFR=154پ} 37 ml/min/1.73 m2. 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.
Pediatr Nephrol (2011) 26:1285–1290 DOI 10.1007/s00467-011-1857-2 Received: 12 August 2010 / Revised: 18 February 2011 / Accepted: 24 February 2011 / Published online: 11 May 2011
