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Early Detection of Renal Complication in Children With Sickle Cell Disease: A Single Center Prospective Study
Raghad Alghorayed1, Bashaer Alsubayni1, Ehab Hanafy2
1Pediatrics, King Salman Armed Forces Hospital, Tabuk, SAU.
Insights
Lower body weight may predict kidney complications in pediatric sickle cell disease (SCD). Routine monitoring of microalbuminuria and kidney, ureter, and bladder (KUB) ultrasounds can aid early detection in children with SCD.
Area of Science:
- Pediatric Nephrology
- Hematology
- Medical Imaging
Background:
- Sickle cell disease (SCD) poses significant risks for renal complications in children.
- Early identification of renal injury predictors is crucial for timely intervention.
- Microalbuminuria and abdominal ultrasound (US) are evaluated as potential early indicators.
Purpose of the Study:
- To identify predictors of renal complications in pediatric patients with sickle cell disease (SCD).
- To explore correlations between microalbuminuria, clinical parameters, and abdominal US findings.
- To assess the association between SCD diagnosis type and renal outcomes.
Main Methods:
- Observational cross-sectional study of 100 pediatric SCD patients (ages 1-14).
- Electronic medical records were analyzed for clinical and laboratory data.
- Kidney, ureter, and bladder (KUB) US findings were correlated with SCD type and patient characteristics.
Main Results:
- No patients tested positive for albuminuria (<30 mg/g creatinine).
- Significant association found between SCD diagnosis and abnormal KUB US findings (p=0.008).
- Lower mean body weight was significantly associated with abnormal KUB US results (p=0.024).
Conclusions:
- SCD diagnosis type is associated with renal US results, and lower body weight may predict renal complications.
- High hydroxyurea (HU) compliance warrants further investigation for its impact on renal outcomes.
- Routine monitoring of microalbuminuria and KUB US is recommended for early detection of renal complications in pediatric SCD.
Introduction:
This observational cross-sectional study aimed to identify predictors of renal complications in pediatric patients with sickle cell disease (SCD) at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia, over six months from February 2023 to July 2023. The study evaluated microalbuminuria as an early indicator of renal injury and explored its correlations with clinical and laboratory parameters and abdominal ultrasound (US) findings.
Methods:
Included were pediatric patients aged 1 to 14 years with confirmed SCD, excluding those with acute infections or pre-existing renal diseases. Data from 100 patients' electronic medical records were analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States), with a significance set at p ≤ 0.05.
Results:
The mean age was 7.6 ± 3.3 years, with 51 males and 49 females; 11 were diagnosed with Hb-S-beta thalassemia. Hydroxyurea (HU) compliance was high, with only four non-compliant patients, though all took folic acid. Among 42 tested for albuminuria, all had negative results (<30 mg/g creatinine). A significant association was found between SCD diagnosis and kidney, ureter, and bladder (KUB) US results (p=0.008), with abnormal KUB findings more prevalent in the Hb-S-beta thalassemia group. Patients with abnormal KUB results had significantly lower mean weight (p=0.024). Additionally, Hb-S-beta thalassemia patients had lower mean weight than hemoglobin SS (HGSS) patients (p=0.04). Though not statistically significant, Hb-S-beta thalassemia patients had higher mean systolic blood pressure (p=0.053).
Conclusion:
Significant associations were identified between SCD diagnosis type and renal US results, with lower body weight emerging as a potential predictor of renal complications. High HU compliance and its impact on renal outcomes warrant further investigation. Routine monitoring of microalbuminuria and KUB US may aid early detection of renal complications in pediatric SCD patients. Further studies with larger sample sizes are recommended to validate these findings and develop comprehensive renal protective strategies.
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