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Renal kallikrein: a risk marker for nephropathy in children with sickle cell disease

Shayla Bergmann1, Deyi Zheng, Julio Barredo

  • 1Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina 29425, USA.

Journal of Pediatric Hematology/Oncology
|May 9, 2006
PubMed

Insights

Urinary kallikrein may indicate progressive kidney damage in children with sickle cell disease (SCD). Higher kallikrein levels correlate with increased albuminuria, suggesting its potential as a risk marker for sickle cell nephropathy (SCN).

Area of Science:

  • Nephrology
  • Pediatrics
  • Hematology

Background:

  • Sickle cell disease (SCD) management has improved survival, but end-organ damage, particularly renal failure (affecting 20% of patients), remains a significant concern.
  • Sickle cell nephropathy (SCN) involves glomerular changes, albuminuria, and declining kidney function, with underlying mechanisms not fully understood.
  • Renal kallikrein's role as a potential risk marker for SCN requires further investigation.

Purpose of the Study:

  • To explore the role of renal kallikrein as a risk marker for promoting sickle cell nephropathy (SCN) in children.
  • To investigate the correlation between urinary kallikrein excretion and markers of kidney damage in children with SCD.

Main Methods:

  • A cross-sectional study measured urinary active kallikrein excretion rates in 73 children with sickle cell anemia (SCD) and 30 healthy controls.
  • Statistical analyses, including cross-sectional and multivariate regression, were used to assess correlations between kallikrein, albumin excretion rate (AER), age, and hemoglobin levels.

Main Results:

  • A significant positive correlation was found between active kallikrein excretion and albumin excretion rate (AER) in children with SCD (P<0.0088).
  • Active kallikrein excretion negatively correlated with hemoglobin levels (P<0.0096), and AER positively correlated with age.
  • Multivariate analysis indicated that age (20%) and log kallikrein (6%) significantly influenced AER variability in children with SCD.

Conclusions:

  • Urinary active kallikrein is positively and independently correlated with AER in children with SCD.
  • Kallikrein may serve as a potential marker for progressive nephropathy in sickle cell disease.
  • Longitudinal studies are recommended to confirm these findings and establish kallikrein's role in SCN progression.
Abstract

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