Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Evaluating risk factors for chronic kidney disease in pediatric patients with sickle cell anemia
source: Pediatric Nephrology
authors: Lebensburger JD, Cutter GR, Howard TH, Muntner P, Feig DIsummary/abstract:
Patients with sickle cell anemia (SCA) have an increased prevalence of nephropathy and mortality from chronic kidney disease (CKD).
We evaluated the association of hyperuricemia and nocturnal hypertension with lower estimated glomerular filtration rate (eGFR) using cystatin-C in patients aged 10-21 years with the HbSS or HbSB0 form of the disease during a non-acute clinic visit. eGFR and uric acid measurements were obtained in 83 and 81 participants, respectively, and 24-h ambulatory blood pressure monitoring (ABPM) was performed in 44 participants. Annual testing included vital signs, complete blood count, comprehensive metabolic panel, medications, urine microalbumin/creatinine, and lactate dehydrogenase measurements. Hyperuricemia was defined as a uric acid level of ≥5.5 mg/dL. Nocturnal hypertension was defined as >25% of nocturnal readings at >95th percentile according to norms established by the American Heart Association Statement on ABPM in children and adolescents.
The mean eGFR was statistically significantly lower in patients with hyperuricemia than in those with normal uric acid levels (143 vs. 161 mL/min/1.73 m2, respectively). Of the 44 participants for whom ABPM data were available, 14 (32%) had systolic nocturnal hypertension and 12 (27%) had diastolic nocturnal hypertension. The mean eGFR was statistically significantly lower in participants with nocturnal systolic and diastolic hypertension than in those with normal nocturnal blood pressure. In a regression model, nocturnal hypertension and hyperuricemia were associated with a lower eGFR.
Two risk factors for CKD, i.e., nocturnal hypertension and hyperuricemia, were associated with lower eGFR in older children and adolescent patients with SCA. Long-term studies on their association with progression to CKD in this population are warranted.
read more full text
Impact of Arginine Therapy on Clinical Outcomes, Mitochondrial Function and Oxidative Stress in Children With Sickle...Introduction: Vaso-occlusive pain episo...
When Cracking Down On Opioids Means Tougher Access For Sickle Cell PatientsMany people with sickle cell disease wil...
Feasibility and acceptability of internet-delivered cognitive behavioral therapy for chronic pain in adolescents wit...Pain is a clinical hallmark of sickle ce...
Marina Jerebtsova, PhDDr Marina Jerebtsova is an assistant pro...
SCD Patients Benefit From Early Rivipansel Treatment for VOCs, New Analyses ShowStarting treatment with rivipansel (GMI-...
Dr. Doris Wethers, 91, on Front Lines against Sickle Cell, DiesDr. Doris L. Wethers, who broke racial b...
Hospitals See No Link Between US Opioid Crisis and Patients’ Use of Treatment, Study ReportsThe U.S. opioid epidemic is not linked t...
The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.