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A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
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Renal function in adult Jamaicans with homozygous sickle cell disease

Monika R Asnani, Marvin E Reid

    Hematology (Amsterdam, Netherlands)
    |November 29, 2014
    PubMed

    Insights

    Renal dysfunction is prevalent in sickle cell disease (SCD) patients, with albuminuria affecting two-thirds of those with hyperfiltration. Serum creatinine is an insensitive marker, highlighting the need for early albuminuria screening in SCD.

    Area of Science:

    • Nephrology
    • Hematology
    • Public Health

    Background:

    • Sickle cell disease (SCD) populations are living longer, increasing the likelihood of renal dysfunction as a significant health challenge.
    • Understanding the prevalence and predictors of kidney disease in SCD is crucial for proactive management.

    Purpose of the Study:

    • To determine the prevalence of renal dysfunction in individuals with SCD.
    • To identify potential predictors of renal dysfunction in this population.

    Main Methods:

    • Ninety-eight patients with homozygous SCD (SS disease) underwent assessment of glomerular filtration rate (GFR) via 99mTc-DTPA nuclear renal scan.
    • Serum creatinine and urinary albumin-to-creatinine ratio were measured, alongside other hematological, biochemical, and clinical data.

    Main Results:

    • 6% of the SCD cohort had chronic kidney disease (CKD) stages 3+, and 65.3% exhibited albuminuria.
    • Hyperfiltration was observed in 24.5% of patients, with two-thirds of these also having albuminuria.
    • Serum creatinine proved to be an insensitive marker, rising significantly only when GFR fell below 50 mL/min/1.73 m²; age was not a predictor.

    Conclusions:

    • Renal dysfunction poses a substantial burden in young adults with SCD.
    • Early screening for albuminuria is recommended, as serum creatinine is a late indicator of declining kidney function.
    • Further longitudinal studies are needed to elucidate the mechanisms of CKD development in SCD.
    Abstract

    Keywords:
    AlbuminuriaChronic kidney diseaseGlomerular filtration rateHyperfiltrationSS disease

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