Early glomerular dysfunction in patients with sickle cell anemia

Schmitt, François; Martinez, Frank; Brillet, Georges; Giatras, Ioannis; Choukroun, Gabriel; Girot, Robert; Bachir, Dora; Galactéros, F; Lacour, Bernard; Jp, Grünfeld

doi:10.1053/ajkd.1998.v32.pm9708603

Cited by 66 publications

(48 citation statements)

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“…The mechanism leading to an increased GFR was previously shown to be associated with enhanced renal blood flow (9,13,18,19), a pathologic feature also detected in early diabetic nephropathy at the stage of hyperfiltration (20). Interestingly, mean mGFR values obtained from microalbuminuric non-insulin-dependent diabetic patients are in about the same order of magnitude (9,21).…”

Section: Discussionmentioning

confidence: 85%

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Glomerular Hyperfiltration in Adult Sickle Cell Anemia

Haymann¹,

Stankovic²,

Lévy³

et al. 2010

Clinical Journal of the American Society of Nephrology

146

144

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Background and objectives: Sickle cell anemia-associated nephropathy is a growing matter of concern because renal failure affects most aging sickle cell anemia patients. Glomerular damage is a common feature revealed by a microalbuminuria or a macroalbuminuria. Although glomerular hyperfiltration has been described for decades in this population, its prevalence in young adults is unknown.Design, setting, participants, & measurements: To address this issue, as well as the clinical and biologic correlates of hyperfiltration, a single-center, cross-sectional study of 280 homozygous SS disease patients was performed.Results: The prevalence of hyperfiltration assessed by Modification of Diet in Renal Disease estimated GFR was 51%. Among patients with hyperfiltration, 49% had hyperfiltration alone, whereas 36% and 15% had an associated microalbuminuria or macroalbuminuria, respectively. Estimated GFR sensitivity and specificity for hyperfiltration were 94% and 63%, respectively, in a selected subgroup of 48 patients (measured GFR was assessed by urinary 51 Cr EDTA clearance). In patients with no albuminuria, hyperfiltration status was significantly associated with a young age (years), the absence of alpha thalassemia, a lower hemoglobin level (g/dl), and a lower fetal hemoglobin. The role of chronic hemolysis was further strengthened by multivariate analysis showing a correlation between estimated GFR and a low plasma fetal hemoglobin level, a young age, and a high reticulocyte count (r 2 ‫؍‬ 0.54). Conclusions: Together, the data suggest that the pathophysiology of hyperfiltration would rather be attributable to the hemolysis-associated vasculopathy rather than a viscosity-vaso-occlusive process.

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Section: Discussionmentioning

confidence: 85%

“…In accordance with this view, the beneficial effects of angiotensinconverting enzyme inhibitors on microalbuminuria have been reported in SCAN patients (7). Surprisingly, although hyperfiltration has been reported in several studies (6,8,9), its prevalence is at present unknown.…”

mentioning

confidence: 67%

Glomerular Hyperfiltration in Adult Sickle Cell Anemia

Haymann¹,

Stankovic²,

Lévy³

et al. 2010

Clinical Journal of the American Society of Nephrology

146

144

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“…4,19 Glomerular hyperfiltration with low filtration fraction appears to be a hallmark of SCAN 20 at an early stage together with microalbuminuria. 19,21 Whereas hyperfiltration seems to be related to increased cardiac output and a hemolytic phenotype, 4 the mechanisms leading to the onset of albuminuria have not yet been defined.…”

Section: Discussionmentioning

confidence: 99%

Hemoglobin sickle cell disease complications: a clinical study of 179 cases

et al. 2012

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“…Renal complications are a well known cause of morbidity and mortality in sickle cell disease, and the incidence of renal failure increases as overall patient survival improves [1][2][3][4][5][6][7][8][9][10]. Early elements of sickle cell renal disease include increased renal plasma flow accompanied by glomerular hyperfiltration and increased proximal tubular function, as well as hematuria.…”

Section: Introductionmentioning

confidence: 99%

Estimated glomerular filtration rate in sickle cell anemia is associated with polymorphisms of bone morphogenetic protein receptor 1B

Nolan

Cohen

et al. 2006

American J Hematol

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Renal disease is common in sickle cell anemia. In this exploratory work, we used data from a longitudinal study of the natural history of sickle cell disease to examine the hypothesis that polymorphisms (SNPs) in selected candidate genes are associated with glomerular filtration rate (GFR). DNA samples and clinical and laboratory data were available for 1,140 patients with sickle cell anemia. GFR was estimated using the Cockcroft-Gault and Schwartz formulas for adults and children, respectively. We examined *175 haplotype tagging (ht) SNPs in about 70 genes of the TGFb/BMP pathway for their association with GFR using linear regression. Four SNPs in BMPR1B, a bone morphogenetic protein (BMP) receptor gene, yielded statistically significant associations (P values ranging from 0.015 to 0.046). Three haplotypes in this gene were also associated with GFR. The TGF-b/BMP pathway has been associated with the development of diabetic nephropathy, which has some features in common with sickle cell nephropathy. Our results suggest that, as with other subphenotypes of sickle cell disease, renal function may be genetically modulated. Am. J. Hematol. 82:179-184, 2007. V V C 2006 Wiley-Liss, Inc.

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Early glomerular dysfunction in patients with sickle cell anemia

Cited by 66 publications

References 0 publications

Glomerular Hyperfiltration in Adult Sickle Cell Anemia

Glomerular Hyperfiltration in Adult Sickle Cell Anemia

Hemoglobin sickle cell disease complications: a clinical study of 179 cases

Estimated glomerular filtration rate in sickle cell anemia is associated with polymorphisms of bone morphogenetic protein receptor 1B

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