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Renal function in children with sickle cell anemia
A Karabay Bayazit1, A Noyan, B Aldudak
1Department of Pediatric Nephrology, Cukurova University School of Medicine, Balcali, Adana, Turkey.
Insights
Children with sickle cell anemia (SCA) show distal tubular abnormalities, not proximal, impacting kidney function. This study highlights consistent renal functional derangements in pediatric SCA patients.
Area of Science:
- Nephrology
- Pediatrics
- Hematology
Background:
- Sickle cell anemia (SCA) is associated with diverse renal dysfunctions.
- Understanding these dysfunctions in childhood is crucial for early intervention.
Purpose of the Study:
- To investigate and demonstrate renal function abnormalities in children with homozygous sickle cell anemia (HbSS).
- To compare renal function between pediatric HbSS patients and healthy children.
Main Methods:
- Renal function studies were conducted on 55 pediatric HbSS patients and 13 healthy controls.
- Hematological and biochemical analyses were performed on blood and timed urine samples.
Main Results:
- Pediatric HbSS patients exhibited higher serum potassium and uric acid levels compared to controls.
- Significantly lower mean tubular phosphate reabsorption and fractional potassium excretion were observed in HbSS patients.
- Patients showed higher urine pH and lower specific gravity and osmolality, indicating distal tubular dysfunction.
Conclusions:
- Distal tubular abnormalities are the most consistent renal functional derangements in children with SCA.
- Significant proximal tubular dysfunction is not a common feature in pediatric SCA patients.
Background:
Patients with sickle cell anemia have various forms of renal dysfunction.
Subjects, Materials And Methods:
The purpose of this study is to demonstrate the abnormalities of HbSS patients' renal function in childhood. Renal function studies were performed in 55 patients with homozygote sickle cell anemia and compared with 13 healthy children. The blood and timed urine samples were obtained for hematological and biochemical determinations.
Results:
Mean serum creatinine, sodium, phosphorus and calcium levels were not statistically different between patients and controls. Mean serum potassium and uric acid levels were significantly higher in patients than in controls. Mean tubular phosphate reabsorption (p < 0.001) and fractional excretion of potassium (p < 0.05) were lower in patients than in the control. There were no significant differences in fractional excretion of sodium and uric acid between patients and controls. Patients had significantly higher urine pH and significantly lower specific gravity and osmolality than controls. Also, there were no significant differences in urinary protein/ creatinine, urinary N-acetyl-beta-D-glucosaminidase/creatinine and urinary malondialdehyde/creatinine between patients and controls.
Conclusion:
Thus, significant proximal tubular dysfunction is not a common feature but distal tubular abnormality is the most consistent renal functional derangement of patients with SCA in childhood.