Sickle cell nephropathy: insights into the pediatric population

Adebayo, Oyindamola C; Heuvel, Lambertus P. van den; Olowu, Wasiu A.; Levtchenko, Elena; Labarque, Veerle

doi:10.1007/s00467-021-05126-4

Cited by 10 publications

(13 citation statements)

References 93 publications

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“…Indeed, the studies that reported lower prevalences of sickle cell nephropathy were mostly conducted in children. 29 , 32 , 33 According to Gosmanova et al 34 and Adebayo et al, 35 the Clinical presentation of sickle cell nephropathy is age-dependent, with kidney dysfunction slowly beginning to develop from childhood, progressing to CKD and kidney failure during the third and fourth decades of life. 11 In SCD patients, Ranque et al observed sickle cell nephropathy in 27% of children younger than 10 years, and its frequency increased with age (48% in SCD patients aged >40 years).…”

Section: Discussionmentioning

confidence: 99%

Renal Abnormalities Among Sickle Cell Disease Patients in a Poor Management Setting: a Survey in the Democratic Republic of the Congo

Kambale‐Kombi

Djang'Eing'A

Opara

et al. 2022

Mediterr J Hematol Infect Dis

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Background & objective: Sickle cell disease (SCD) is now a well-established cause of renal damage. In the northeast of the Democratic Republic of Congo (DRC), SCD is common. However, sickle cell nephropathy remains unstudied in this region. Thus, this study aimed to assess renal abnormalities in SCD patients in Kisangani (northeastern DRC). Methods: This cross-sectional study included 98 sickle cell patients selected from six health facilities in Kisangani and 89 healthy non-sickle cell subjects as the control group. Based on a survey form, a clinical examination and biological tests were performed to collect data related to the sex, age, weight, height, blood pressure, serum creatinine, serum uric acid, urinary albumin/creatinine ratio, and hemoglobin phenotype. We used a spectrophotometer to measure serum creatinine and uricemia, the sickle SCAN® device for hemoglobin phenotype, and an automatic multifunction analyzer for urine albumin/creatinine ratio. Data were entered into an Excel file and analyzed on SPSS 20.0. Results: The mean urine albumin-to-creatinine ratio was 11.79±9.03 mg/mmol in SCD patients, significantly higher than in AA (1.69±1.89 mg/mmol) and AS (2.97±4.46 mg/mmol) subjects. The decrease in glomerular filtration rate was more observed in SCD patients with hyperuricemia compared to those with normal uric acid levels. A significantly elevated prevalence of chronic kidney disease was observed among SCD patients (87.8%) compared to 23.8% in AS and 7.7% in AA subjects. Conclusions: This study highlighted that albuminuria and chronic kidney disease are common in SCD patients in Kisangani. More studies are needed to document these complications further. Keywords: Sickle cell disease, prevalence, sickle cell nephropathy, renal abnormalities, Democratic Republic of the Congo, sub-Saharan Africa.

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Section: Discussionmentioning

confidence: 99%

Renal Abnormalities Among Sickle Cell Disease Patients in a Poor Management Setting: a Survey in the Democratic Republic of the Congo

Kambale‐Kombi

Djang'Eing'A

Opara

et al. 2022

Mediterr J Hematol Infect Dis

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“…Kidney damage is one of the most common complications of SCD, with approximately 30% of sickle cell patients developing chronic kidney disease (CKD) and 14-18% progressing to a terminal kidney. 2 SCD is a particular challenge in the paediatric population, as it begins in early childhood with signs of structural changes detected as glomerular hyperfiltration leading to albuminuria, loss of renal function, and AKI. 2 However, these low-level changes can progress undetected to advanced CKD in late adolescence or early adulthood.…”

Section: Introductionmentioning

confidence: 99%

“…2 SCD is a particular challenge in the paediatric population, as it begins in early childhood with signs of structural changes detected as glomerular hyperfiltration leading to albuminuria, loss of renal function, and AKI. 2 However, these low-level changes can progress undetected to advanced CKD in late adolescence or early adulthood. 2,3 Current improvements in the care of sickle cell patients allow for relatively longer survival, leading to an increased incidence of sickle cell nephropathy and AKI.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of renal function of sickle cell children in Libreville by estimation of glomerular creatinine-cystatin C filtration rate: prevalence of acute kidney injury and associated factors

Mintoo,

Loembe,

Mpira

et al. 2024

Int J Contemp Pediatr

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Background: Sickle cell disease (SCD) is an important and growing global health problem. Kidney damage is one of the most common complications of SCD. We aimed to determine the prevalence of acute kidney injury (AKI) in children with SCD in our context. Methods: Cross-sectional and analytical study from January 2022 to September 2022, including SCD children aged from 6 months to 17 years during their hospitalisation. We measured the estimated glomerular filtration (eGFR) rate using the combined creatinine and cystatin C formula for kids (CKiDScr-Cys C). Univariate analyses were performed to measure the relationship between variables and AKI and eGFR, followed by a multivariate analysis using logistic regression. Results: Of the 137 children, we included 82 boys (60%) and 55 girls (40%). The mean eGFR was 112±45.3 ml/min/1.73 m2. A total of 36 subjects, or 26.3% (95% CI [18.9-33.6%)), had acute AKI. Comparison of characteristics by AKI status showed significant differences according the number of transfusions (p<0.01), and hemoglobin level (p<0.027), eGFR had a negative correlation with the number of transfusions r=-0.308 (-0.477; -0.117); p<0.01. Multivariate analysis showed that nutritional status was a protective factor of AKI (p<0.01), and the number of transfusions was a predictive factor of AKI in SCD in our context (p<0.001). Conclusions: The results from our study are an urgent alarm to implement the existing management programs on SCD from screening to universal access of hydroxyurea in order to reduce complications and mortality related to this pathology.

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“…Children with SCD are vulnerable to AKI for several reasons including repeated reperfusion injury following vaso‐occlusion, chronic haemolysis and recurrent infections 5,6 . Further vulnerability to AKI in SCD stems from the hypoxic and acidic environment of the kidney medulla that promotes red blood cell sickling, the higher likelihood of dehydration from polyuria and the need for nephrotoxic agents such as non‐steroidal anti‐inflammatory drugs (NSAIDs) and aminoglycosides during painful crisis and bacterial infections, respectively.…”

Section: Introductionmentioning

confidence: 99%

“…chronic haemolysis and recurrent infections. 5,6 Further vulnerability to AKI in SCD stems from the hypoxic and acidic environment of the kidney medulla that promotes red blood cell sickling, the higher likelihood of dehydration from polyuria and the need for nephrotoxic agents such as non-steroidal anti-inflammatory drugs (NSAIDs) and aminoglycosides during painful crisis and bacterial infections, respectively. Despite this heightened vulnerability, AKI in children with SCD has not received much attention.…”

mentioning

confidence: 99%

Acute kidney injury is more common in hospitalised children with sickle cell anaemia in Africa

Joacquim,

Akinsete,

Esezobor

2023

Acta Paediatrica

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AimTo document the prevalence, severity, hospital outcome and factors associated with acute kidney injury (AKI) in hospitalised children with sickle cell anaemia (SCA).MethodsIn this prospective observational study involving children aged 0.5–17 years with SCA requiring hospitalisation, we used serum creatinine level at 0 and 48 h of hospitalisation to determine the presence of AKI.ResultsThe study involved 155 children with SCA aged 0.5–17 years with a median (interquartile range) age of 7.8 (4.3–11.0) years. Acute kidney injury occurred in 27 (17.4%) children with 33.3% reaching stage 3. Hepatomegaly (81.5% vs. 55.4%; p = 0.015), splenomegaly (33.3% vs. 10.9%; p = 0.003), dipstick proteinuria (22.2% vs. 5.4%; p = 0.004), and hematuria (29.6% vs. 3.1%; p = <0.001) were more common in those with AKI. In contrast, children with AKI had lower haematocrit (16.9% vs. 22.2%; p = <0.001) and serum bicarbonate (16.7 vs. 19.1 mmoL/L; p = 0.010) compared with those without AKI. Those with AKI had longer hospital stay (median [interquartile range]: 7 [4–12] days vs. 4 [3–6] days; p = 0.008).ConclusionAKI is common among hospitalised children with AKI and is associated with longer hospital stay.

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Sickle cell nephropathy: insights into the pediatric population

Cited by 10 publications

References 93 publications

Renal Abnormalities Among Sickle Cell Disease Patients in a Poor Management Setting: a Survey in the Democratic Republic of the Congo

Renal Abnormalities Among Sickle Cell Disease Patients in a Poor Management Setting: a Survey in the Democratic Republic of the Congo

Evaluation of renal function of sickle cell children in Libreville by estimation of glomerular creatinine-cystatin C filtration rate: prevalence of acute kidney injury and associated factors

Acute kidney injury is more common in hospitalised children with sickle cell anaemia in Africa

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