Chronic kidney disease is common in sickle cell disease: a cross-sectional study in the Tema Metropolis, Ghana

BMC Nephrology

Prince Adoba³  Hope Agbodzakey³  Juliana Mitchell²  Lyudmila Asante-Asamani²  Enos Amoako Oduro³  Obed Cudjoe³  Derick Nii Mensah Osakunor¹  Richard Kobina Dadzie Ephraim³ 

[1]Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, College of Health Sciences, Kumasi, Ghana

[2]Sickle Cell Unit, Tema General Hospital, Tema, Ghana

[3]Medical Laboratory Division, Department of Medical Laboratory Technology, UCC, Cape Coast, Ghana

关键词: Sickle cell disease;    HbSC;    HbSS;    Ghana;    Chronic kidney disease;   

Others  :  1209045
DOI  :  10.1186/s12882-015-0072-y

 received in 2014-12-05, accepted in 2015-05-21,  发布年份 2015

【 摘 要 】

Background

Renal involvement in sickle cell disease (SCD) contributes significantly to morbidity and mortality. The aim of this study was to determine the prevalence of chronic kidney disease (CKD) amongst SCD patients, and how basic clinical variables differ across haemoglobin genotypes.

Methods

A hospital-based cross-sectional study conducted from December 2013 to May 2014 at the Sickle cell clinic of the Tema General Hospital. One hundred and ninety-four (194) participants with SCD, receiving medical care at the outpatient sickle cell clinic were enrolled onto the study. A structured questionnaire was administered to obtain information on demography, clinical history, blood pressure and anthropometry. Blood and urine samples were taken for serum creatinine and proteinuria determination respectively. The estimated GFR (eGFR) was calculated using the CKD-EPI and Schwartz equations. CKD was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Analysis was performed using GraphPad prism and P <0.05 was considered statistically significant.

Results

CKD was present in 39.2 % of participants. Using KDIGO guidelines, 40.8 % of the HbSS participants had stage 1 CKD and none had stage 2 CKD. In addition, 30.8 % of the HbSC participants had stage 1 CKD and 3.8 % had stage 2 CKD. There was a trend of increasing age across CKD stages and stage 2 CKD participants were oldest (P < 0.001).

Conclusion

Results from the current study suggest that CKD is common amongst SCD patients and prevalence and intensity increases with age. Proteinuria and CKD was more common in HbSS genotype than in HbSC genotype.

【 授权许可】

   
2015 Ephraim et al.; licensee BioMed Central.

【 参考文献 】

• [1]McPherson Yee M, Jabbar SF, Osunkwo I, Clement L, Lane PA, Eckman JR, Guasch A. Chronic kidney disease and albuminuria in children with sickle cell disease. Clin J Am Soc Nephrol. 2011; 6(11):2628-2633.
• [2]Powars, Elliot-Mills DD, Chan L, Hiti AL, Opas LM, Johnson C. Chronic renal failure in sickle cell disease: Risk factors, clinical course, and mortality. Ann Intern Med. 1991; 115:614-620.
• [3]Ohene-Frempong K, Oduro J, Tetteh H, Nkrumah F. Screening newborns for sickle cell disease in Ghana. Paediatrics. 2008; 121:S120-S121.
• [4]Konotey-Ahulu FID. The Sickle Cell Disease Patient London and Basingstoke: Macmillan Publsihing Company. 1991.
• [5]Falk RJ, Scheinman J, Phillips G, Orringer E, Johnson A, Jennette JC. Prevalence and pathologic features of sickle cell nephropathy and response to inhibition of angiotensin-converting enzyme. N Engl J Med. 1992; 326(14):910-915.
• [6]Platt RS, Brambilla DJ, Rosse WF, Milner PF, Castro O, Steinberg MH, Klug PP. Mortality in sickle cell disease. N Engl J Med. 1994; 330:1639-1644.
• [7]Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T et al.. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009; 150(9):604-612.
• [8]Serjeant GR, Serjeant BE. Sickle Cell Disease, 3rd ed. edn. Oxford University Press, Oxford, United Kingdom; 2001.
• [9]Saborio P, Scheinman JI. Sickle cell nephropathy. J Am Soc Nephrol. 1999; 10(1):187-192.
• [10]Kadiri S: Chronic kidney disease: Sickle cell nephropathy as a likely cause. Annals of Ibadan Postgraduate Med 2006;4:7-10.
• [11]Day TG, Drasar ER, Fulford T, Sharpe CC, Thein SL. Association between hemolysis and albuminuria in adults with sickle cell anemia. Haematologica. 2012; 97(2):201-205.
• [12]Haymann JP, Stankovic K, Levy P, Avellino V, Tharaux PL, Letavernier E, Grateau G, Baud L, Girot R, Lionnet F. Glomerular hyperfiltration in adult sickle cell anemia: a frequent hemolysis associated feature. Clin J Am Soc Nephrol. 2010; 5(5):756-761.
• [13]Allon M. Renal abnormalities in sickle cell disease. Arch Intern Med. 1990; 150(3):501-504.
• [14]Schmitt F, Martinez F, Brillet G, Giatras I, Choukroun G, Girot R, Bachir D, Galacteros F, Lacour B, Grunfeld JP. Early glomerular dysfunction in patients with sickle cell anemia. Am J Kidney Dis. 1998; 32(2):208-214.
• [15]Kirkendall WM, Burton AC, Epstein FH, Freis ED. Recommendations for human blood pressure determination by sphygmomanometers. Circulation. 1967; 36(6):980-988.
• [16]Adult BMI [http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html]
• [17]Gonzalez-Casanova I, Sarmiento OL, Gazmararian JA, Cunningham SA, Martorell R, Pratt M, Stein AD. Comparing three body mass index classification systems to assess overweight and obesity in children and adolescents. Rev Panam Salud Publica. 2013; 33(5):349-355.
• [18]BMI for children and teens [http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html]
• [19]KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney interSuppl. 2013; 3(1):1-150.
• [20]Schwartz GJ, Brion LP, Spitzer A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatric Clinics of North America. 1987; 34(3):571-590.
• [21]Schwartz GJ, Munoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, Furth SL. New equations to estimate GFR in children with CKD. Am Soc Nephrol. 2009; 20(3):629-637.
• [22]Arlet JB, Ribeil JA, Chatellier G, Eladari D, De Seigneux S, Souberbielle JC, Friedlander G, de Montalembert M, Pouchot J, Prie D et al.. Determination of the best method to estimate glomerular filtration rate from serum creatinine in adult patients with sickle cell disease: a prospective observational cohort study. BMC Nephrology. 2012; 13:83. BioMed Central Full Text
• [23]Stevens PE, Levin A. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2012; 158(11):825-830.
• [24]Chaiken RL, Eckert-Norton M, Bard M, Banerji MA, Palmisano J, Sachimechi I, Lebovitz HE. Hyperfiltration in African-American patients with type 2 diabetes. Cross-sectional and longitudinal data. Diabetes care. 1998; 21(12):2129-2134.
• [25]Pruijm M, Wuerzner G, Maillard M, Bovet P, Renaud C, Bochud M, Burnier M. Glomerular hyperfiltration and increased proximal sodium reabsorption in subjects with type 2 diabetes or impaired fasting glucose in a population of the African region. Nephrol Dial Transplant. 2010; 25(7):2225-2231.
• [26]Gosmanova EO, Zaidi S, Wan JY, Adams-Graves PE. Prevalence and progression of chronic kidney disease in adult patients with sickle cell disease. J Investig Med. 2014; 62(5):804-807.
• [27]Guasch A, Navarrete J, Nass K, Zayas CF. Glomerular involvement in adults with sickle cell hemoglobinopathies: Prevalence and clinical correlates of progressive renal failure. J Am Soc Nephrol. 2006; 17(8):2228-2235.
• [28]Bodas P, Huang A, O'Riordan MA, Sedor JR, Dell KM. The prevalence of hypertension and abnormal kidney function in children with sickle cell disease -a cross sectional review. BMC Nephrology. 2013; 14:237. BioMed Central Full Text
• [29]Bolarinwa RA, Akinlade KS, Kuti MA, Olawale OO, Akinola NO. Renal disease in adult Nigerians with sickle cell anemia: a report of prevalence, clinical features and risk factors. Saudi J Kidney Dis Transpl. 2012; 23(1):171-175.
• [30]Homi J, Homi-Levee L, Gentles S, Thomas P, Serjeant G. Adolescent blood pressure in a cohort study of sickle cell disease. Arch Intern Med. 1993; 153(10):1233-1236.
• [31]Thompson J, Reid M, Hambleton I, Serjeant GR. Albuminuria and renal function in homozygous sickle cell disease: observations from a cohort study. Arch Intern Med. 2007; 167(7):701-708.
• [32]Gladwin MT, Sachdev V, Jison ML, Shizukuda Y, Plehn JF, Minter K, Brown B, Coles WA, Nichols JS, Ernst I et al.. Pulmonary hypertension as a risk factor for death in patients with sickle cell disease. N Engl J Med. 2004; 350(9):886-895.
• [33]Jaja SI, Opesanwo O, Mojiminiyi FB, Kehinde MO. Lung function, haemoglobin and irreversibly sickled cells in sickle cell patients. West Afr J Med. 2000; 19(3):225-229.
• [34]Nahavandi M, Wyche MQ, Perlin E, Tavakkoli F, Castro O. Nitric Oxide Metabolites in Sickle Cell Anemia Patients after Oral Administration of Hydroxyurea; Hemoglobinopathy. Hematology. 2000; 5(4):335-339.
• [35]Belhassen L, Pelle G, Sediame S, Bachir D, Carville C, Bucherer C, Lacombe C, Galacteros F, Adnot S. Endothelial dysfunction in patients with sickle cell disease is related to selective impairment of shear stress-mediated vasodilation. Blood. 2001; 97(6):1584-1589.