Renal abnormalities among children with sickle cell conditions in highly resource-limited setting in Ghana


Autoři: Enoch Odame Anto aff001;  Christian Obirikorang aff001;  Emmanuel Acheampong aff001;  Eric Adua aff002;  Sampson Donkor aff001;  Bright Oppong Afranie aff001;  Matthew Ofori aff003;  Emmanuel Akomanin Asiamah aff004;  Evans Asamoah Adu aff001
Působiště autorů: Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana aff001;  School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia aff002;  Department of Medical Laboratory Technology, Royal Ann College of Health, Atwima-Manhyia, Kumasi, Ghana aff003;  Department of Medical Laboratory Science, University of Health and Allied Sciences, Ho, Ghana aff004
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0225310

Souhrn

Sickle cell disease (SCD) is associated with progressive multi-organ failure especially, the brain and kidney and leads to high morbidity and mortality rate. The aim of this study was to determine the prevalence of renal abnormalities among children with SCD. This cross-sectional study recruited 212 sickling positive patients comprising of 96 Hb AS, 48 Hb SC, and 68 Hb SS phenotypes from the Pediatric Unit of Wassa Akropong Government Hospital, Wassa Akropong, Ghana. Early morning urine and venous blood samples were collected from each participant. Urinalysis was conducted and serum urea and creatinine levels were estimated. Estimate glomerular filtration rate (eGFR) was calculated using the Swartz equation. Classification of chronic kidney disease (CKD) was based on ‘The Kidney Disease: Improving Global Outcomes (KIDIGO)’ criteria. The mean age of the children were 7.90 years. Serum creatinine (p = 0.0310) and urea (p<0.0001) levels were significantly higher among Hb AS participants compared with Hb SS phenotype. The prevalent indicators of renal abnormalities were proteinuria (26.4%), urine granular cast (5.6%) and CKD (39.6%). Proteinuria, urine granular cast and CKD were most prevalent among Hb SS (47.1%, 11.8% and 73.5% respectively) compared with Hb SC (41.7%, 8.3%, and 45.8% respectively) and Hb AS (4.2%, 0.0%, and 14.5%) phenotypes, respectively. Sickle cell conditions were significantly associated with proteinuria (p<0.0001) and CKD (p = 0.0378). Children with Hb SS [aOR = 5.04, 95% CI (2.47–10.3); p<0.0001] and Hb SC [aOR = 3.14 95% CI (1.39–7.01); p = 0.0174] were at increased odds of developing CKD after adjusting for age, BMI and gender. Proteinuria and CKD are associated with sickle cell disease (Hb SC and Hb SS). Renal function should be routinely monitored for children with SCD.

Klíčová slova:

Creatinine – Ghana – Chronic kidney disease – Kidneys – Proteinuria – Sickle cell disease – Urea – Urine


Zdroje

1. Anie KA, Egunjobi FE, Akinyanju OO. Psychosocial impact of sickle cell disorder: perspectives from a Nigerian setting. Globalization and Health. 2010;6(1):2.

2. Yee MM, Jabbar SF, Osunkwo I, Clement L, Lane PA, Eckman JR, et al. Chronic kidney disease and albuminuria in children with sickle cell disease. Clin J Am Soc Nephrol. 2011;6(11):2628–2633. doi: 10.2215/CJN.01600211 21940843

3. World Health Organization. Worldwide prevalence of anaemia 1993–2005. WHO global database on anaemia. 2008.

4. Ohene-Frempong K, Oduro J, Tetteh H, Nkrumah F. Screening newborns for sickle cell disease in Ghana. Pediatrics. 2008;121(2):S120–S21.

5. Antwi-Boasiako C, Donkor ES, Sey F, Dzudzor B, Dankwah GB, Otu KH, et al. Levels of Soluble Endothelium Adhesion Molecules and Complications among Sickle Cell Disease Patients in Ghana. Diseases. 2018;6(2): 29.

6. Antwi-Boasiako C, Frimpong E, Ababio GK, Dzudzor B, Ekem I, Gyan B, et al. Sickle Cell Disease: Reappraisal of the role of Foetal Haemoglobin Levels in the frequency of Vaso-Occlusive crisis. Ghana Med. J. 2015;49(2): 102–106. 26339094

7. 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. doi: 10.1056/NEJM199204023261402 1542341

8. Palmer C, Bik EM, DiGiulio DB, Relman DA, Brown PO. Development of the human infant intestinal microbiota. PLoS Biol. 2007;5(7):e177. doi: 10.1371/journal.pbio.0050177 17594176

9. Bunn AG. A dendrochronology program library in R (dplR). Dendrochronologia. 2008;26(2):115–24.

10. Nath KA, Hebbel R P. Sickle cell disease: renal manifestations and mechanisms. Nature reviews. Nephrology. 2015;11(3): 161–171. doi: 10.1038/nrneph.2015.8 25668001

11. Camus SM, De Moraes JA, Bonnin P, Abbyad P, Le Jeune S, Lionnet F, et al. (2015). Circulating cell membrane microparticles transfer heme to endothelial cells and trigger vasoocclusions in sickle cell disease. Blood, 125(24), 3805–3814. doi: 10.1182/blood-2014-07-589283 25827830

12. Platt OS, Brambilla DJ, Rosse WF, Milner PF, Castro O, Steinberg MH, et al. Mortality in sickle cell disease—life expectancy and risk factors for early death. N Engl J Med. 1994;330(23):1639–1644. doi: 10.1056/NEJM199406093302303 7993409

13. Bonventre JV, Yang L. Cellular pathophysiology of ischemic acute kidney injury. J Clin Invest. 2011;121(11):4210–4221. doi: 10.1172/JCI45161 22045571

14. Ataga KI, Derebail VK, Archer DR. The glomerulopathy of sickle cell disease. American journal of hematology. 2014;89(9): 907–914. doi: 10.1002/ajh.23762 24840607

15. Ataga KI, Moore CG, Jones S, Olajide O, Strayhorn D, Hinderliter A, et al. Pulmonary hypertension in patients with sickle cell disease: a longitudinal study. British journal of haematology. 2006;134(1): 109–115. doi: 10.1111/j.1365-2141.2006.06110.x 16803576

16. Guasch A, Navarrete J, Nass K, Zayas CF. Glomerular involvement in adults with sickle cell hemoglobinopathies: prevalence and clinical correlates of progressive renal failure. Clin J Am Soc Nephrol. 2006;17(8):2228–2235.

17. Ephraim RK, Osakunor DN, Cudjoe O, Oduro EA, Asante-Asamani L, Mitchell J, et al. Chronic kidney disease is common in sickle cell disease: a cross-sectional study in the Tema Metropolis, Ghana. BMC Nephrology. 2015; 16(1):75.

18. Dennis-Antwi JA, Dyson S, Ohene-Frempong K. Healthcare provision for sickle cell disease in Ghana: challenges for the African context. Diversity in Health & Social Care. 2008;5(4):241–245

19. Allon M. Renal abnormalities in sickle cell disease. Arch Intern Med. 1990;150(3):501–504. 2178577

20. Schmitt F, Martinez F, Brillet G, Giatras I, Choukroun G, Girot R, et al. Early glomerular dysfunction in patients with sickle cell anemia. Am J Kidney Dis. 1998;32(2):208–214. doi: 10.1053/ajkd.1998.v32.pm9708603 9708603

21. Schwartz GJ, Muñoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009;20(3):629–637. doi: 10.1681/ASN.2008030287 19158356

22. Levey AS, Eckardt K-U, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney international. 2005;67(6):2089–2100. doi: 10.1111/j.1523-1755.2005.00365.x 15882252

23. Osei-Yeboah C, Rodrigues O, Enweronu-Laryea C. Nutritional status of children with sickle cell disease at Korle Bu Teaching Hospital, Accra, Ghana. West African journal of medicine. 2011;30(4):262–267. 22669830

24. Boadu I, Ohemeng A, Renner LA. Dietary intakes and nutritional status of children with sickle cell disease at the Princess Marie Louise Hospital, Accra–a survey. BMC Nutrition. 2018;4(1):33.

25. Mian AN, Schwartz GJ. Measurement and Estimation of Glomerular Filtration Rate in Children. Advances in chronic kidney disease. 2017;24(6):348–356. doi: 10.1053/j.ackd.2017.09.011 29229165

26. Stenvinkel P, Heimbürger O, Lindholm B, Kaysen GA, Bergström J. Are there two types of malnutrition in chronic renal failure? Evidence for relationships between malnutrition, inflammation and atherosclerosis (MIA syndrome). Nephrology Dialysis Transplantation. 2000;15(7):953–960.

27. Ouyang Y, Xie J, Yang M, Zhang X, Ren H, Wang W, et al. Underweight Is an Independent Risk Factor for Renal Function Deterioration in Patients with IgA Nephropathy. PloS one. 2016;11(9):e0162044. doi: 10.1371/journal.pone.0162044 27611091

28. Lukusa Kazadi A, Ngiyulu RM, Gini-Ehungu JL, Mbuyi-Muamba JM, Aloni MN. Factors associated with growth retardation in children suffering from sickle cell anemia: First report from central Africa. Anemia. 2017.

29. Marsenic O, Couloures KG, Wiley JM. (2007). Proteinuria in children with sickle cell disease. Nephrology Dialysis Transplantation. 2007;23(2):715–720.

30. Howard J, Telfer P. Sickle cell disease in clinical practice. Springer London. 2015.

31. Anigilaje EA, Adedoyin OT. Persistent proteinuria among sickle cell anaemia children in steady state in Ilorin, Nigeria. Int. J. Med. Med. Sci. 2016;8(3):30–35.

32. Scheinman JI. Sickle cell disease and the kidney. Nature Reviews Nephrology. 2009;5(2): 78.

33. Saborio P, Scheinman JI. Sickle cell nephropathy. J Am Soc Nephrol. 1999;10(1):187–92. 9890326

34. Scheinman JI. Sickle cell nephropathy. Pediatri Nephrology: Sixt Completely Revised, Updated and Enlarged Edition. 2009:1181–1197.

35. Gowda S, Desai PB, Kulkarni SS, Hull VV, Math AA, Vernekar SN. Markers of renal function tests. N Am J Med Sci. 2010;2(4):170. 22624135

36. Hoefield RA, Kalra PA, Baker PG, Sousa I, Diggle PJ, Gibson MJ, et al. The use of eGFR and ACR to predict decline in renal function in people with diabetes. Nephrol Dial Transplant. 2010;26(3):887–92. doi: 10.1093/ndt/gfq526 20837749

37. Alvarez O, Miller ST, Wang WC, Luo Z, McCarville MB, Schwartz GJ, et al. Effect of hydroxyurea treatment on renal function parameters: Results from the multi-center placebo-controlled BABY HUG clinical trial for infants with sickle cell anemia. Pediatric blood & cancer. 2012;59(4):668–674

38. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med. 1999;130(6):461–470. doi: 10.7326/0003-4819-130-6-199903160-00002 10075613

39. Rule AD, Larson TS, Bergstralh EJ, Slezak JM, Jacobsen SJ, Cosio FG. Using serum creatinine to estimate glomerular filtration rate: accuracy in good health and in chronic kidney disease. Ann Intern Med. 2004;141(12):929–937. doi: 10.7326/0003-4819-141-12-200412210-00009 15611490

40. Gargiulo R, Pandya M, Seba A, Haddad RY, Lerma EV. Sickle cell nephropathy. Disease- a-Month. 2014;60(10):494–499. doi: 10.1016/j.disamonth.2014.08.004 25282510


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PLOS One


2019 Číslo 11
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