Progressive Decline in Estimated GFR in Patients With Sickle Cell Disease: An Observational Cohort Study

Rapid decline in estimated glomerular filtration rate is common in adults with sickle cell disease and associated with increased mortality

“…Glomerular filtration rate progressively declines with age, with an annual rate of decline of kidney function of 1·27 ± 1·97 ml/min/1·73 m 2 reported in African‐American adults (Young et al , ). Multiple previous studies suggest that kidney function progressively declines in SCD (Gosmanova et al , ; Asnani et al , ; van Tuijn et al , ; Xu et al , ; Derebail et al , ). In a 25‐year prospective longitudinal demographic and clinical cohort study, 31 out of 725 patients with HbSS (4·2%) and 5 out of 209 patients with HbSC disease (2·4%) developed chronic renal failure (Powars et al , ).…”

“…The study design and participants of this study have been described previously (Derebail et al , ). Briefly, patients with SCD aged at least 18 years, followed at a single academic medical centre from 2004 to 2013, were identified via medical record review.…”

“…Albuminuria is the most frequently assessed marker of kidney damage in clinical practice and occurs in up to 68% of adult patients with SCD (Ataga et al , ). Although the natural history of CKD in patients with SCD remains inadequately defined, multiple studies suggest that kidney function declines at a more rapid rate in SCD than in healthy individuals (Asnani et al , ; Xu et al , ; Derebail et al , ). We and others have reported on the prevalence of CKD as well as the rate of decline in estimated glomerular filtration rate (eGFR) in adults with SCD (Asnani et al , ; Xu et al , ; Derebail et al , ).…”

“…Although the natural history of CKD in patients with SCD remains inadequately defined, multiple studies suggest that kidney function declines at a more rapid rate in SCD than in healthy individuals (Asnani et al , ; Xu et al , ; Derebail et al , ). We and others have reported on the prevalence of CKD as well as the rate of decline in estimated glomerular filtration rate (eGFR) in adults with SCD (Asnani et al , ; Xu et al , ; Derebail et al , ). In our earlier publication, the baseline prevalence of CKD in this patient cohort was 19·9%, with an annual rate of decline in eGFR among individuals with HbSS and HbSβ 0 thalassaemia of 2·05 ml/min/1·73 m 2 per year (Derebail et al , ).…”

“…We and others have reported on the prevalence of CKD as well as the rate of decline in estimated glomerular filtration rate (eGFR) in adults with SCD (Asnani et al , ; Xu et al , ; Derebail et al , ). In our earlier publication, the baseline prevalence of CKD in this patient cohort was 19·9%, with an annual rate of decline in eGFR among individuals with HbSS and HbSβ 0 thalassaemia of 2·05 ml/min/1·73 m 2 per year (Derebail et al , ). Prior studies in other populations, including patients with hypertension and diabetes, have demonstrated that those with more rapid decline in kidney function had higher mortality (Rifkin et al , ; Shlipak et al , ).…”