Early blood transfusions protect against microalbuminuria in children with sickle cell disease

Álvarez, Ofelia; Montané, Brenda; López, Gabriela Blasco; Wilkinson, James D.; Miller, Tracie L.

doi:10.1002/pbc.20645

Cited by 79 publications

(107 citation statements)

References 21 publications

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“…35 Two further studies, however, found that chronic transfusion made no difference to the onset of proteinuria. 36,37 Although it seems logical that chronic transfusion could be effective at preventing many of the renal complications of SCD, this therapy is not a minor undertaking, and evidence of its benefits is needed before it can be justified for the treatment or prevention of SCN.…”

Section: Other Preventative or Early Treatment Options Red Cell Transmentioning

confidence: 95%

How I treat renal complications in sickle cell disease

Sharpe

Thein

2014

Blood

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Renal disease is one of the most frequent and severe complications experienced by patients with sickle cell disease; its prevalence is likely to increase as the patient population ages. We recommend regular monitoring for early signs of renal involvement and a low threshold for the use of hydroxyurea as preventative measures for end-stage renal disease. Once renal complications are detected, a careful assessment of the patient is required to rule out other causes of renal disease. Proteinuria and hypertension should be managed aggressively and the patient referred to a specialist nephrology center when progressive decline in renal function is noted. For the few patients who develop advanced chronic kidney disease, timely planning for dialysis and transplantation can significantly improve outcome, and we recommend an exchange blood transfusion policy for all patients on the transplant waiting list and for those with a functioning graft. Alongside the invasive treatment regimes, it is important to remember that renal failure in conjunction with sickle cell disease does carry a significant burden of morbidity and that focusing on symptom control has to be central to good patient care.

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Section: Other Preventative or Early Treatment Options Red Cell Transmentioning

confidence: 95%

How I treat renal complications in sickle cell disease

Sharpe

Thein

2014

Blood

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“…In a cross-sectional study of 410 patients with SCD aged 2-21 (mean age 11) years, 23% had the HbSS form of SCD, with elevated urinary albumin excretion (≥30 mg/g), while other investigators have reported a HbSS prevalence of 16-27% in the childhood SCD population [18,20,21]. Further progressive kidney injury and CKD is reflected in a declining and abnormally low GFR.…”

Section: Sickle Cell Nephropathy In Childrenmentioning

confidence: 99%

Acute kidney injury in children with sickle cell disease—compounding a chronic problem

2017

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In an article recently published in Pediatric Nephrology, Baddam and colleagues discuss the relatively underreported clinical problem of repeated episodes of acute kidney injury (AKI) in children with sickle cell disease (SCD). Their report is a cautionary note about the importance of repeated kidney injury on the background of underlying chronic kidney injury and its potential implications on long-term kidney outcome. In children and adults with SCD, this includes the effects of repeated vaso-occlusive crises and the management of these painful episodes with non-steroidal anti-inflammatory drugs. Here we review the scope of kidney involvement in SCD in children and discuss the potential short-and long-term consequences of AKI in children with SCD.

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“…In one study a urinary screening of asymptomatic SCD patients revealed microalbuminuria in 15.8% of patients [7]. Another study indicated that 22.3% of SCD patients had microalbuminuria [8].…”

Section: Discussionmentioning

confidence: 99%

“…40% of causes of mortality among adult SCD patients were due to renal failure [6]. Several published studies identified microalbuminuria and proteinuria as major renal manifestations among adult SCD patients [7] [8]. In this study, we focused on renal manifestations of adult Sudanese patients with SCD.…”

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confidence: 99%

Renal Manifestations among Adult Sickle Cell Disease Patients: A Single Center Study in Khartoum, Sudan

Banaga¹,

Elhardlu²,

Elmusharaf³

2016

OJNeph

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Sickle Cell Disease (SCD) in adults is one of the causes of renal abnormalities and Chronic Kidney Disease (CKD). In this retrospective study, we explore the renal manifestations among adult SCD patients. The subjects of the study are all adult patients diagnosed with sickle cell anaemia and admitted as to the Academy Charity Teaching Hospital, Khartoum/Sudan during the period (01/01/2015-31/12/2015). All adult SCD patients' medical files have been reviewed focusing on personal and clinical data in addition to presence or absence of renal manifestations, a total of 51 adult patients with SCD have been admitted to Academy Charity Teaching Hospital, Khartoum/ Sudan. 11 patients have renal manifestations (21.5%). The mean age ± SD of SCD patients with renal manifestations was 20.2 ± 1.9 years, 63.6% were males, the mean Hb level was 6.9 ± 0.99 gm/dl, proteinuria was present among 81.8% of patients, followed by haematuria (36.4%) and End Stage Renal Failure (ESRF) (18.2%). Further prospective studies are needed to explore the renal abnormalities among adult SCD patients.

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Early blood transfusions protect against microalbuminuria in children with sickle cell disease

Abstract: We conclude that: (1) children with sickle cell hemoglobinopathies 10 years or older should be screened for MA and (2) chronic transfusions starting at an early age may be renoprotective.

Cited by 79 publications

References 21 publications

How I treat renal complications in sickle cell disease

How I treat renal complications in sickle cell disease

Acute kidney injury in children with sickle cell disease—compounding a chronic problem

Renal Manifestations among Adult Sickle Cell Disease Patients: A Single Center Study in Khartoum, Sudan

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