Original Article

Pediatric Nephrology

, Volume 25, Issue 8, pp 1505-1511

First online:

Prevalence and clinical correlates of microalbuminuria in children with sickle cell disease

  • Lauren J. BectonAffiliated withDepartment of Pediatrics, Medical University of South Carolina Children’s Hospital
  • , Ram V. KalpatthiAffiliated withPediatric Hematology and Oncology, Children’s Mercy Hospital
  • , Elizabeth RackoffAffiliated withPediatric Hematology and Oncology, Medical University of South Carolina Children’s Hospital
  • , Deborah DiscoAffiliated withPediatric Hematology and Oncology, Medical University of South Carolina Children’s Hospital
  • , John K. OrakAffiliated withPediatric Nephrology, Medical University of South Carolina Children’s Hospital
  • , Sherron M. JacksonAffiliated withPediatric Hematology and Oncology, Medical University of South Carolina Children’s Hospital
  • , Ibrahim F. ShatatAffiliated withPediatric Nephrology, Medical University of South Carolina Children’s HospitalDivision of Nephrology, CSB-316, MUSC Children’s Hospital Email author 

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Abstract

Sickle cell disease (SCD) is associated with a large spectrum of renal abnormalities, one of which, microalbuminuria/proteinuria (MA/P), is a known predictor of end-stage renal disease. We studied 90 children with SCD (57% male; mean age 11.4 ± 5.2 years) to determine the prevalence and examine clinical correlates of MA/P. The average of two spot urine microalbumin-to-creatinine samples obtained 6 months apart was recorded. Medical records were reviewed for demographic and biochemical data. Medication use, resting office blood pressures (BP), vaso-occlusive pain crises (VOC), and monthly transfusions were recorded. Fourteen children (15.5%) had MA/P. Hemoglobin (Hb) levels were significantly lower in the children with MA than in those without MA/P (8.8 ± 1.1 vs. 9.8 ± 1.4 g/dL, respectively) and were significantly correlated with MA (rho = 0.24, p = 0.03). Children with MA were more likely to have abnormal BP (p = 0.058), with 5/14 being hypertensive or pre-hypertensive. In a multivariate logistic regression model of MA, both Hb and BP classification remained in the final model. MA is a simple screening biomarker of early kidney injury in children with SCD. Larger studies to evaluate predictive factors of MA and the relationship to BP are needed.

Keywords

Hypertension Microalbuminuria Pediatrics Proteinuria Sickle cell disease