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Proteinuria is associated with elevated tricuspid regurgitant jet velocity in children with sickle cell disease

Suzanne Forrest1, Ashley Kim, Judith Carbonella

  • 1Yale University School of Medicine, New Haven, CT, USA.

Pediatric Blood & Cancer
|October 13, 2011
PubMed

Insights

Elevated pulmonary artery pressures are linked to proteinuria in children with sickle cell disease (SCD). This finding suggests a connection between pulmonary hypertension and kidney issues in pediatric SCD patients.

Area of Science:

  • Pediatric Nephrology
  • Cardiology in Sickle Cell Disease
  • Echocardiography in Pediatric Practice

Background:

  • Sickle cell disease (SCD) impacts multiple organ systems, with pulmonary hypertension (PHT) and sickle cell nephropathy (SCN) being serious complications.
  • PHT and SCN share risk factors, and in adults, PHT is associated with albuminuria, a marker of SCN.
  • Data on the association between PHT and SCN markers in children with SCD is lacking.

Purpose of the Study:

  • To investigate the association between elevated pulmonary artery systolic pressures and proteinuria in pediatric patients with SCD.
  • To determine if echocardiogram-estimated pulmonary artery pressures correlate with kidney damage markers in children with SCD.

Main Methods:

  • Retrospective chart review of pediatric SCD patients screened via echocardiogram between June 2005 and July 2010.
  • Inclusion criteria: initial echocardiogram and urine analysis within one year, with longitudinal data collection.
  • Analysis focused on tricuspid regurgitant jet velocity (TRV) and presence of proteinuria.

Main Results:

  • Eighty-five pediatric SCD patients were included; 32.9% had elevated TRV (≥2.5 m/s) on initial echocardiogram.
  • Proteinuria was observed in 7.14% of patients with elevated TRV versus 1.75% without elevated TRV at initial screening.
  • On follow-up, 19.08% of repeat urinalyses showed proteinuria in patients with elevated baseline TRV, compared to 12.35% in those with normal TRV (P=0.04).

Conclusions:

  • Elevated tricuspid regurgitant jet velocity (TRV) ≥2.5 m/s is significantly associated with proteinuria in children with SCD.
  • This association suggests a potential link between pulmonary hypertension and kidney dysfunction in pediatric SCD.
  • Findings highlight the importance of monitoring for SCN in children with SCD and signs of PHT.
Abstract

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