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Renal function in infants with sickle cell anemia: baseline data from the BABY HUG trial

Russell E Ware1, Renee C Rees, Sharada A Sarnaik

  • 1St. Jude Children's Research Hospital, Memphis, TN 38105, USA. russell.ware@stjude.org

The Journal of Pediatrics
|November 3, 2009
PubMed

Insights

Glomerular filtration rate (GFR) measurement is feasible in infants with sickle cell anemia (SCA). However, quantitative DTPA GFR values show variability and are not well-correlated with Schwartz estimates, indicating early renal dysfunction.

Area of Science:

  • Pediatric Nephrology
  • Hematology
  • Clinical Trials

Background:

  • Sickle cell anemia (SCA) is a genetic blood disorder associated with chronic organ damage.
  • Early detection of renal dysfunction is crucial for managing SCA complications.
  • Glomerular filtration rate (GFR) is a key indicator of kidney function.

Purpose of the Study:

  • To assess the feasibility and accuracy of measuring GFR in infants with SCA.
  • To compare quantitative GFR measurements with estimated GFR values in this population.

Main Methods:

  • Utilized data from the BABY HUG Phase III clinical trial.
  • Measured GFR quantitatively using technetium 99m-labeled diethylenetriaminepentaacetic acid (DTPA) plasma clearance.
  • Estimated GFR using the Schwartz equation based on height and creatinine.

Main Results:

  • Quantitative GFR measurement was feasible in 96% of infants studied.
  • Average DTPA GFR was 125.2 mL/min/1.73m(2), while Schwartz estimates were higher at 184.4 mL/min/1.73m(2).
  • DTPA GFR showed significant correlations with age, weight, height, and kidney volume, but not with SCA-specific biomarkers or clinical events.

Conclusions:

  • Quantitative GFR measurement is achievable in infants with SCA, though results exhibit variability.
  • Schwartz equation estimates do not strongly correlate with quantitative DTPA GFR measurements in this age group.
  • Findings suggest that glomerular hyperfiltration, an early sign of renal dysfunction, is present in infants with SCA.
Abstract

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