A comprehensive assessment of renal function in patients with Gaucher disease.
BACKGROUND
Gaucher disease (GD) is caused by deficiency of acid beta-glucocerebrosidase and is the most common lysosomal storage disease. Patients may have massive hepatosplenomegaly, severe bone disease, and, occasionally, pulmonary or neurological involvement. Although other storage diseases, such as Fabry disease, frequently affect the kidneys, reports of renal abnormalities in patients with GD are limited to case reports. Our aim was to perform a comprehensive evaluation of renal function in patients with GD.


METHODS
Evaluation was performed at routine clinic visits and included blood pressure recording and renal ultrasound. Serum chemistries, urinalysis, urine electrolytes, total protein, and tubular proteinuria were assessed, and estimated glomerular filtration rate (GFR) was calculated.


RESULTS
One hundred sixty-one patients underwent evaluation, including 26 children. GFR was significantly greater in patients with GD than in age- and sex-matched healthy controls (P = 0.01 in men, P < 0.001 in women, P = 0.003 in children). Subgroups of patients with markers of more severe disease had a greater GFR than other patients. No patient had decreased renal function. Significant proteinuria was found only in patients with such comorbidities as diabetes mellitus or multiple myeloma. No evidence of renal tubular abnormalities was found, and kidney sonographic appearance and size were normal.


CONCLUSIONS
Despite the multiorgan nature of the disease, a systematic evaluation did not find renal abnormalities in patients with GD. Glomerular hyperfiltration was observed in a proportion of patients, particularly those with markers of more severe disease. This phenomenon does not seem to be associated with a subsequent decline in renal function.
Becker-Cohen
Rachel
R
Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel. rbeckercohen@yahoo.com
Elstein
Deborah
D
Abrahamov
Ayala
A
Algur
Nurit
N
Rudensky
Bernard
B
Hadas-Halpern
Irith
I
Zimran
Ari
A
Frishberg
Yaacov
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018912:Arabs / Q000235:genetics; D002118:Calcium / Q000652:urine; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D005776:Gaucher Disease / Q000208:ethnology / Q000235:genetics / Q000503:physiopathology* / Q000652:urine; D005838:Genotype; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007223:Infant; D007585:Jews / Q000235:genetics; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007684:Kidney Tubules / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000209:etiology; D014463:Ultrasonography; D001613:beta 2-Microglobulin / Q000652:urine
D001613:beta 2-Microglobulin; D003404:Creatinine; D002118:Calcium