title: Albuminuria, serum antioxidant enzyme levels and markers of hemolysis and inflammation in steady state children with sickle cell anemia.
abstract: Oxidative stress is thought to be involved in the pathogenesis of microalbuminuria in Sickle cell anemia (SCA). Antioxidant enzymes such as glutathione peroxidase (GPx) and Cu-Zn superoxide dismutase (SOD) may play an important protective role. This study aimed to evaluate the association between albuminuria and these two antioxidant enzymes.
  
  
  
  We consecutively recruited Steady state children aged between 2 and 18 years old with established diagnosis of homozygous SCA in two hospitals of Kinshasa/DR Congo. The relationship between Urinary Albumin Creatinine Ratio (UACR) and other variables of interest (age, systolic blood pressure, diastolic blood pressure, plasma GPx and Cu-Zn SOD, free plasmatic hemoglobin, LDH, indirect bilirubin, white blood cells (WBC), percentage of fetal hemoglobin, serum iron, ferritin, CRP) was analyzed by Bivariate correlation (Pearson's correlation coefficient). Microalbuminuria was defined by urine albumin/creatinine ratio between 30 and 299 mg/g.
  
  
  
  Seventy Steady state Black African children with SCA (56% boys; average age 9.9 ± 4.3 years; 53% receiving hydroxyurea) were selected. Prevalence of microalbuminuria was 11.8%. LDH (r = 0.260; p = 0.033) and WBC count (r = 0.264; p = 0.033) were positively correlated with UACR whereas GPx (- 0.328; p = 0.007) and Cu-Zn SOD (- 0.210; p = 0.091) were negatively correlated with UACR.
  
  
  
  Albuminuria is associated with decreased antioxidant capacity and increased levels of markers of hemolysis and inflammation. Therefore, strategies targeting the reduction of sickling and subsequent hemolysis, oxidative stress and inflammation could help preventing or at least delaying the progression of kidney disease in SCA children.
authors.affiliation: Division of Hematology, Oncology and Nephrology, Department of Pediatric, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Itokua
authors.affiliation: Nephrology Unit, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo. jrmakulo2016@gmail.com.|Faculty of Medicine, University of Kinshasa Hospital, Kinshasa, Democratic Republic of the Congo. jrmakulo2016@gmail.com.
authors.forename: Jean Robert
authors.initials: JR
authors.lastname: Makulo
authors.affiliation: Nephrology Unit, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: François B
authors.initials: FB
authors.lastname: Lepira
authors.affiliation: Division of Hematology, Oncology and Nephrology, Department of Pediatric, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Michel N
authors.initials: MN
authors.lastname: Aloni
authors.affiliation: Division of Hematology, Oncology and Nephrology, Department of Pediatric, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Pépé M
authors.initials: PM
authors.lastname: Ekulu
authors.affiliation: Nephrology Unit, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Ernest K
authors.initials: EK
authors.lastname: Sumaili
authors.affiliation: Nephrology Unit, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Justine B
authors.initials: JB
authors.lastname: Bukabau
authors.affiliation: Nephrology Unit, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Vieux M
authors.initials: VM
authors.lastname: Mokoli
authors.affiliation: Nephrology Unit, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Augustin L
authors.initials: AL
authors.lastname: Longo
authors.affiliation: Nephrology Unit, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: François M
authors.initials: FM
authors.lastname: Kajingulu
authors.affiliation: Nephrology Unit, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Chantal V
authors.initials: CV
authors.lastname: Zinga
authors.affiliation: Nephrology Unit, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Yannick M
authors.initials: YM
authors.lastname: Nlandu
authors.affiliation: Nephrology Unit, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Yannick M
authors.initials: YM
authors.lastname: Engole
authors.affiliation: Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Pierre Z
authors.initials: PZ
authors.lastname: Akilimali
authors.affiliation: Division of Hematology, Oncology and Nephrology, Department of Pediatric, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: René M
authors.initials: RM
authors.lastname: Ngiyulu
authors.affiliation: Division of Hematology, Oncology and Nephrology, Department of Pediatric, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Jean Lambert
authors.initials: JL
authors.lastname: Gini
authors.affiliation: Nephrology Unit, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Nazaire M
authors.initials: NM
authors.lastname: Nseka
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000201:enzymology / Q000652:urine*; D000755:Anemia, Sickle Cell / Q000235:genetics / Q000378:metabolism*; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D005979:Glutathione Peroxidase / Q000097:blood*; D006461:Hemolysis; D006720:Homozygote; D006801:Humans; D007249:Inflammation / Q000097:blood; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D018384:Oxidative Stress; D000072105:Superoxide Dismutase-1 / Q000097:blood*
chemical_list: D015415:Biomarkers; D003404:Creatinine; D007770:L-Lactate Dehydrogenase; D005979:Glutathione Peroxidase; D000072105:Superoxide Dismutase-1
keywords: Albuminuria; Cu-Zn SOD; GPx; Inflammation; Lactate dehydrogenase; Sickle cell anemia