| Glomerular hyperfiltration in adult sickle cell anemia: a frequent hemolysis associated feature. | |
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MedLine Citation:
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PMID: 20185605 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVES: Sickle cell anemia-associated nephropathy is a growing matter of concern because renal failure affects most aging sickle cell anemia patients. Glomerular damage is a common feature revealed by a microalbuminuria or a macroalbuminuria. Although glomerular hyperfiltration has been described for decades in this population, its prevalence in young adults is unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: To address this issue, as well as the clinical and biologic correlates of hyperfiltration, a single-center, cross-sectional study of 280 homozygous SS disease patients was performed. RESULTS: The prevalence of hyperfiltration assessed by Modification of Diet in Renal Disease estimated GFR was 51%. Among patients with hyperfiltration, 49% had hyperfiltration alone, whereas 36% and 15% had an associated microalbuminuria or macroalbuminuria, respectively. Estimated GFR sensitivity and specificity for hyperfiltration were 94% and 63%, respectively, in a selected subgroup of 48 patients (measured GFR was assessed by urinary (51)Cr EDTA clearance). In patients with no albuminuria, hyperfiltration status was significantly associated with a young age (years), the absence of alpha thalassemia, a lower hemoglobin level (g/dl), and a lower fetal hemoglobin. The role of chronic hemolysis was further strengthened by multivariate analysis showing a correlation between estimated GFR and a low plasma fetal hemoglobin level, a young age, and a high reticulocyte count (r(2) = 0.54). CONCLUSIONS: Together, the data suggest that the pathophysiology of hyperfiltration would rather be attributable to the hemolysis-associated vasculopathy rather than a viscosity-vaso-occlusive process. |
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Authors:
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Jean-Philippe Haymann; Katia Stankovic; Pierre Levy; Virginie Avellino; Pierre-Louis Tharaux; Emmanuel Letavernier; Gilles Grateau; Laurent Baud; Robert Girot; François Lionnet |
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Publication Detail:
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Type: Journal Article Date: 2010-02-25 |
Journal Detail:
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Title: Clinical journal of the American Society of Nephrology : CJASN Volume: 5 ISSN: 1555-905X ISO Abbreviation: Clin J Am Soc Nephrol Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-10 Completed Date: 2010-08-12 Revised Date: 2011-07-28 |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 756-61 Citation Subset: IM |
Affiliation:
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Université Pierre et Marie Curie, Université Paris 6, Institut National de la Santé et de la Recherche Médicale Unit 702, Physiology, Paris, France. jean-philippe.haymann@tnn.aphp.fr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Albuminuria / blood, epidemiology*, physiopathology Anemia, Sickle Cell / blood, epidemiology*, genetics, physiopathology Cross-Sectional Studies Female France / epidemiology Glomerular Filtration Rate* Hemoglobin, Sickle / genetics Hemolysis* Homozygote Humans Kidney / physiopathology* Linear Models Logistic Models Male Middle Aged Prevalence Renal Insufficiency / blood, epidemiology*, genetics, physiopathology Risk Assessment Risk Factors Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobin, Sickle |
| Comments/Corrections | |
Comment In:
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Clin J Am Soc Nephrol. 2010 May;5(5):748-9
[PMID:
20299367
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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