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Changes in Urine Microalbumin-to-Creatinine Ratio in Children with Sickle Cell Disease over Time

Ibrahim F Shatat1, Suparna Qanungo2, Shannon Hudson2

  • 1Pediatric Nephrology and Hypertension, Sidra Medical and Research Center, Doha, Qatar; College of Nursing, Medical University of South Carolina, Charleston, SC, USA; Weill Cornell Medical College, New York, NY, USA.

Frontiers in Pediatrics
|October 25, 2016
PubMed

Insights

Microalbuminuria (MA) in children with sickle cell disease (SCD) can fluctuate over time. Age and bilirubin levels predict MA increase in transfused patients, highlighting the need for further renal injury research.

Area of Science:

  • Pediatric Nephrology
  • Hematology
  • Sickle Cell Disease Research

Background:

  • Microalbuminuria (MA) affects approximately 20% of children with sickle cell disease (SCD).
  • Limited data exists on the progression of MA in pediatric and young adult SCD populations.
  • MA is recognized as an early indicator of renal injury in this demographic.

Purpose of the Study:

  • To analyze the progression of microalbuminuria in children and young adults with SCD.
  • To determine the rate, direction, magnitude, and predictors of microalbuminuria-to-creatinine (MA/Cr) ratio changes over a 5-year period.
  • To investigate factors influencing MA/Cr fluctuations in pediatric SCD patients.

Main Methods:

  • Retrospective analysis of 5-year electronic medical record (EMR) data.
  • Inclusion of 373 children with SCD and at least two MA/Cr ratio measurements.
  • Utilized multivariate logistic regression to identify predictors of MA/Cr change.

Main Results:

  • Of 45 children with baseline MA, 47% persisted with MA, while 24 new cases developed and 24 normalized during follow-up.
  • Age and bilirubin levels were significant predictors of MA/Cr increase in patients receiving blood transfusions.
  • Initial MA level was not a predictor of subsequent MA/Cr change.

Conclusions:

  • Microalbuminuria levels in children and young adults with SCD can increase or decrease over time.
  • Further research is essential to validate MA as a long-term renal injury marker in SCD.
  • Identifying high-risk individuals for worsening MA is crucial for proactive management.
Abstract

Keywords:
childrenmicroalbuminuriaprogressionsickle cell nephropathyyoung adults

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