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Albuminuria correlates with hemolysis and NAG and KIM-1 in patients with sickle cell anemia

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Abstract

Background

Although hyperfiltration and albuminuria are common pathological conditions, kidney injury (KI) biomarkers have been seldom studied in individuals with sickle cell anemia (SCA).

Methods

We undertook a cross-sectional assessment of urine KI biomarkers in children and adults with SCA with and without albuminuria and a normal estimated glomerular filtration rate (eGFR). Albumin, KI molecule 1 (KIM-1), N-acetyl-ß-D-glucosaminidase (NAG), endothelin-1 and transforming growth factor-β1 (TGF-β1) were measured. Assays were normalized by urine creatinine. Urine intracellular hemosiderin and serum lactate dehydrogenase (LDH) were assessed as markers of hemolysis. Albuminuria was associated to the biomarkers by Pearson and Spearman correlation coefficients. Differences between the albuminuria (yes, no) groups were assessed by the t test.

Results

Nineteen patients with albuminuria (mean urine albumin/creatinine 527.14 ± 1070 mg/g, range 38.3-–190 mg/g) and 19 patients without albuminuria (mean urine albumin/creatinine 15.93 ± 5.17 mg/g, range 7.9–28.4 mg/g) were studied. The age range for the whole group was 11–48 years, and 47 % were males. Patients with albuminuria were older, had lower hematocrit, were more likely to test positive for urine hemosiderin and had a higher KIM-1 (P = 0.0035) and NAG/ creatinine ratios (P = 0.0062). Urine hemosiderin strongly correlated to a higher LDH level (P < 0.001).

Conclusions

Despite a normal or increased eGFR, KI biomarkers were detected in the urine of individuals with SCA. NAG, KIM-1 and urine hemosiderin correlated with the presence of albuminuria.

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Acknowledgments

We acknowledge the kind support of Dr. Lanetta Jordan who provided funding to conduct this study.

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Authors and Affiliations

  1. Division of Pediatric Hematology (D-820), University of Miami, PO Box 016960, Miami, FL, 33101, USA

    Dima Hamideh & Ofelia Alvarez

  2. Division of Pediatric Nephrology, University of Miami, Miami, FL, USA

    Vimal Raj & Gaston Zilleruelo

  3. Division of Hematology, University of Miami, Miami, FL, USA

    Thomas Harrington

  4. Department of Public Health Sciences, University of Miami, Miami, FL, USA

    Hua Li

  5. Department of Pathology and Laboratory Medicine, University of Miami, Miami, FL, USA

    Emilio Margolles, Folasade Amole, Monica Garcia-Buitrago & Phillip Ruiz

  6. Department of Surgery, University of Miami, Miami, FL, USA

    Phillip Ruiz

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  1. Dima Hamideh
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Correspondence to Ofelia Alvarez.

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Hamideh, D., Raj, V., Harrington, T. et al. Albuminuria correlates with hemolysis and NAG and KIM-1 in patients with sickle cell anemia. Pediatr Nephrol 29, 1997–2003 (2014). https://doi.org/10.1007/s00467-014-2821-8

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  • DOI: https://doi.org/10.1007/s00467-014-2821-8

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