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Chronic kidney disease and albuminuria in children with sickle cell disease

Marianne McPherson Yee1, Shameem F Jabbar, Ifeyinwa Osunkwo

  • 1Department of Pediatrics, Division of Hematology/Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA. Marianne.McPherson@choa.org

Clinical Journal of the American Society of Nephrology : CJASN
|September 24, 2011
PubMed

Insights

Sickle cell nephropathy is common in children, with high rates of albuminuria and chronic kidney disease (CKD) detected early. Early detection of kidney damage in sickle cell disease (SCD) is crucial for preventing future renal failure.

Area of Science:

  • Pediatric Nephrology
  • Hematology
  • Genetics

Background:

  • Sickle cell nephropathy is a progressive complication of sickle cell disease (SCD), often beginning in childhood.
  • Albuminuria serves as an early indicator of glomerular damage and potential chronic kidney disease (CKD).

Purpose of the Study:

  • To determine the prevalence of albuminuria and CKD in pediatric patients with SCD.
  • To identify clinical factors associated with albuminuria and CKD in this population.

Main Methods:

  • A cross-sectional study of 410 pediatric SCD patients (ages 2-21) over 10 years.
  • Measurement of urinary albumin-to-creatinine ratio (ACR) and serum creatinine.
  • Classification of CKD stages based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria.

Main Results:

  • Abnormal albuminuria was present in 20.7% of patients, higher in HbSS/HbSβ(0) (23.0%) than HbSC/HbSβ(+) (16.8%).
  • CKD was identified in 26.5% of patients, with stages 1 and 2 being most common.
  • Increasing age and HbSC/HbSβ(+) genotype were associated with CKD in multivariate analysis.

Conclusions:

  • This study is the first to stage CKD in children with SCD, revealing a high early prevalence of albuminuria and glomerular injury.
  • Early detection and staging of CKD in children with SCD are vital for timely interventions to prevent adult renal failure.
Abstract

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