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Changes in Urine Microalbumin-to-Creatinine Ratio in Children with Sickle Cell Disease over Time

BACKGROUND: Approximately 20% of children with sickle cell disease (SCD) have microalbuminuria (MA). Very little is known about the progression of MA in children and young adults with SCD. METHODS: In this study, we analyzed 5-year EMR data of 373 children [with ≥2 microalbumin-to-creatinine (MA/Cr)...

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Autores principales: Shatat, Ibrahim F., Qanungo, Suparna, Hudson, Shannon, Laken, Marilyn A., Hailpern, Susan M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053981/
https://www.ncbi.nlm.nih.gov/pubmed/27774444
http://dx.doi.org/10.3389/fped.2016.00106
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author Shatat, Ibrahim F.
Qanungo, Suparna
Hudson, Shannon
Laken, Marilyn A.
Hailpern, Susan M.
author_facet Shatat, Ibrahim F.
Qanungo, Suparna
Hudson, Shannon
Laken, Marilyn A.
Hailpern, Susan M.
author_sort Shatat, Ibrahim F.
collection PubMed
description BACKGROUND: Approximately 20% of children with sickle cell disease (SCD) have microalbuminuria (MA). Very little is known about the progression of MA in children and young adults with SCD. METHODS: In this study, we analyzed 5-year EMR data of 373 children [with ≥2 microalbumin-to-creatinine (MA/Cr) ratio measurements] followed at the Medical University of South Carolina to determine the rate, direction, magnitude, and predictors of MA/Cr change over time. RESULTS: Age range was 1–22 years; mean 10.2 ± 5.2 years, 49.5% were males. Median follow-up duration was 3.12 ± 1.16 years. At baseline, 328 children had normal (<20 mg/L) MA level. Forty-five (12.1%) of children had MA (≥20 mg/L), of which 91% were ≥8 years and 21 (47%) continued to have MA at the end of the study period. On the other hand, during the study period, 24 new patients developed MA and 24 normalized their MA to levels <20 mg/L. In multivariate logistic regression model, age and bilirubin levels were predictive of MA/Cr increase in patients who received at least one blood transfusion during the study period. Baseline MA level was not predictive of the change in MA/Cr. CONCLUSION: In children and young adults, microalbuminuria is considered a marker of early renal injury. Over time, MA/Cr levels may increase or decrease. Further studies are needed to confirm our findings, assess the reliability of MA as marker of long-term renal injury, and identify high risk patients with SCD likely to have worsening of MA over time.
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spelling pubmed-50539812016-10-21 Changes in Urine Microalbumin-to-Creatinine Ratio in Children with Sickle Cell Disease over Time Shatat, Ibrahim F. Qanungo, Suparna Hudson, Shannon Laken, Marilyn A. Hailpern, Susan M. Front Pediatr Pediatrics BACKGROUND: Approximately 20% of children with sickle cell disease (SCD) have microalbuminuria (MA). Very little is known about the progression of MA in children and young adults with SCD. METHODS: In this study, we analyzed 5-year EMR data of 373 children [with ≥2 microalbumin-to-creatinine (MA/Cr) ratio measurements] followed at the Medical University of South Carolina to determine the rate, direction, magnitude, and predictors of MA/Cr change over time. RESULTS: Age range was 1–22 years; mean 10.2 ± 5.2 years, 49.5% were males. Median follow-up duration was 3.12 ± 1.16 years. At baseline, 328 children had normal (<20 mg/L) MA level. Forty-five (12.1%) of children had MA (≥20 mg/L), of which 91% were ≥8 years and 21 (47%) continued to have MA at the end of the study period. On the other hand, during the study period, 24 new patients developed MA and 24 normalized their MA to levels <20 mg/L. In multivariate logistic regression model, age and bilirubin levels were predictive of MA/Cr increase in patients who received at least one blood transfusion during the study period. Baseline MA level was not predictive of the change in MA/Cr. CONCLUSION: In children and young adults, microalbuminuria is considered a marker of early renal injury. Over time, MA/Cr levels may increase or decrease. Further studies are needed to confirm our findings, assess the reliability of MA as marker of long-term renal injury, and identify high risk patients with SCD likely to have worsening of MA over time. Frontiers Media S.A. 2016-10-07 /pmc/articles/PMC5053981/ /pubmed/27774444 http://dx.doi.org/10.3389/fped.2016.00106 Text en Copyright © 2016 Shatat, Qanungo, Hudson, Laken and Hailpern. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Shatat, Ibrahim F.
Qanungo, Suparna
Hudson, Shannon
Laken, Marilyn A.
Hailpern, Susan M.
Changes in Urine Microalbumin-to-Creatinine Ratio in Children with Sickle Cell Disease over Time
title Changes in Urine Microalbumin-to-Creatinine Ratio in Children with Sickle Cell Disease over Time
title_full Changes in Urine Microalbumin-to-Creatinine Ratio in Children with Sickle Cell Disease over Time
title_fullStr Changes in Urine Microalbumin-to-Creatinine Ratio in Children with Sickle Cell Disease over Time
title_full_unstemmed Changes in Urine Microalbumin-to-Creatinine Ratio in Children with Sickle Cell Disease over Time
title_short Changes in Urine Microalbumin-to-Creatinine Ratio in Children with Sickle Cell Disease over Time
title_sort changes in urine microalbumin-to-creatinine ratio in children with sickle cell disease over time
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053981/
https://www.ncbi.nlm.nih.gov/pubmed/27774444
http://dx.doi.org/10.3389/fped.2016.00106
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