title: Prevalence and clinical correlates of microalbuminuria in children with sickle cell disease.
abstract: Sickle cell disease (SCD) is associated with a large spectrum of renal abnormalities, one of which, microalbuminuria/proteinuria (MA/P), is a known predictor of end-stage renal disease. We studied 90 children with SCD (57% male; mean age 11.4 +/- 5.2 years) to determine the prevalence and examine clinical correlates of MA/P. The average of two spot urine microalbumin-to-creatinine samples obtained 6 months apart was recorded. Medical records were reviewed for demographic and biochemical data. Medication use, resting office blood pressures (BP), vaso-occlusive pain crises (VOC), and monthly transfusions were recorded. Fourteen children (15.5%) had MA/P. Hemoglobin (Hb) levels were significantly lower in the children with MA than in those without MA/P (8.8 +/- 1.1 vs. 9.8 +/- 1.4 g/dL, respectively) and were significantly correlated with MA (rho = 0.24, p = 0.03). Children with MA were more likely to have abnormal BP (p = 0.058), with 5/14 being hypertensive or pre-hypertensive. In a multivariate logistic regression model of MA, both Hb and BP classification remained in the final model. MA is a simple screening biomarker of early kidney injury in children with SCD. Larger studies to evaluate predictive factors of MA and the relationship to BP are needed.
authors.affiliation: Department of Pediatrics, Medical University of South Carolina Children's Hospital, Charleston, SC, 29425, USA.
authors.forename: Lauren J
authors.initials: LJ
authors.lastname: Becton
authors.forename: Ram V
authors.initials: RV
authors.lastname: Kalpatthi
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rackoff
authors.forename: Deborah
authors.initials: D
authors.lastname: Disco
authors.forename: John K
authors.initials: JK
authors.lastname: Orak
authors.forename: Sherron M
authors.initials: SM
authors.lastname: Jackson
authors.forename: Ibrahim F
authors.initials: IF
authors.lastname: Shatat
mesh_terms: D000419:Albuminuria / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control*; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000453:epidemiology*; D001794:Blood Pressure; D001803:Blood Transfusion; D002648:Child; D003404:Creatinine; D006454:Hemoglobins; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011507:Proteinuria / Q000150:complications / Q000453:epidemiology; D057170:Translational Research, Biomedical
chemical_list: D006454:Hemoglobins; D003404:Creatinine