title: Cystatin C, Beta2 Microglobulin, N-Acetyl-beta-D-glucosaminidase, Retinol-Binding Protein, and Endothelin 1 Levels in the Evaluation of Sickle Cell Disease Nephropathy.
abstract: OBJECTIVE
  Renal involvement is common in sickle cell disease (SCD). Early demonstration of renal injury and commencement of appropriate treatment will increase survival and quality of life in these patients. We investigated renal manifestations in our pediatric and adult SCD patients and evaluated the role of cystatin C, Beta2 microglobulin (B2M), retinol-binding protein (RBP), N-acetyl-beta-D-glucosaminidase (NAG), and endothelin-1 (ET-1) to indicate renal damage.
  
  
  METHODS
  The study involved 45 pediatric and 10 adult patients with SCD and 20 healthy children and 10 healthy adults as a control. All the patients were questioned for possible renal manifestations. 24-hour urine samples were collected and glomerular filtration rates (GFRs) were calculated by using creatinine (GFR(creatinine)), Schwartz formula (GFR(Schwartz)), and cystatin C (GFR(cystatin C)). Blood and urine samples were collected and serum cystatin C, urine B2M, RBP, NAG, and ET-1 levels were measured.
  
  
  RESULTS
  Nocturnal enuresis and proteinuria were the most common renal manifestations in SCD patients. When the groups were compared in terms of GFR, GFR(creatinine) and GFR(Schwartz) levels were higher in group 1 and 2 patients than in control 1 and 2 patients (P < .05). Cystatin C, B2M, RBP, NAG, and ET-1 values were normal in both the patient and the control groups. However, B2M/creatinine levels were higher than 160 μg/mg creatinine levels in 10 patients.
  
  
  CONCLUSIONS
  Serum cystatin C, urine NAG, RBP, and ET-1 levels were found to be insufficient for the evaluation of SCD nephropathy. Increased B2M/creatinie levels can be valuable in estimating possible glomerular and tubular damage in SCD.
authors.affiliation: Faculty of Medicine, Department of Pediatrics, Hematology Unit (SU), Nephrology Unit (AD), Mersin University , Mersin , Turkey.
authors.forename: Selma
authors.initials: S
authors.lastname: Unal
authors.forename: Caglar
authors.initials: C
authors.lastname: Kotan
authors.forename: Ali
authors.initials: A
authors.lastname: Delibas
authors.forename: Yesim
authors.initials: Y
authors.lastname: Oztas
mesh_terms: D000118:Acetylglucosaminidase / Q000097:blood / Q000652:urine; D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications / Q000652:urine; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood / Q000652:urine; D019332:Endothelin-1 / Q000097:blood / Q000652:urine; D005260:Female; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000652:urine; D008297:Male; D008875:Middle Aged; D054840:Retinol-Binding Proteins, Cellular / Q000097:blood / Q000652:urine; D001613:beta 2-Microglobulin / Q000097:blood / Q000652:urine
chemical_list: C525030:CST3 protein, human; D055316:Cystatin C; D019332:Endothelin-1; C518456:RBP1 protein, human; D054840:Retinol-Binding Proteins, Cellular; D001613:beta 2-Microglobulin; D003404:Creatinine; D000118:Acetylglucosaminidase
keywords: N-acetyl-beta-D-glucosaminidase; beta2 microglobin; cystatin C; endothelin-1; nephropathy; retinol-binding protein; sickle cell disease