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镰状细胞贫血患儿的微量白蛋白尿

Microalbuminuria in children with sickle cell anemia.

作者信息

Imuetinyan Blessing Abhulimen-Iyoha, Okoeguale Michael Ibadin, Egberue Gabriel Ofovwe

机构信息

Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria.

出版信息

Saudi J Kidney Dis Transpl. 2011 Jul;22(4):733-8.

Abstract

Microalbuminuria (MA) is an early marker of various diseases affecting the renal system. Its relevance in children with sickle cell anemia (SCA), who are known to be prone to renal complications, has not been fully explored, particularly in the study locale. Besides, its occurrence in this group of patients remains under-reported in locations where the burden of SCA is enormous. To assess its prevalence in this cohort, 69 children with sickle cell anemia (in their steady state), aged 1-16 years, were consecutively enrolled and evaluated. The study, spanning from November 2006 to February 2007, was cross-sectional and descriptive. Employing a semiquantitative method, MA in an early morning spot urine sample was determined in each subject. Also evaluated were the anthropometry, blood pressure (BP) and packed cell volume. Prevalence of MA in the study subjects was 20.3%. Though not significant, prevalence of MA was more in females (25.9%) than in males (16.7%). Prevalence of MA increased with increasing age and was also significantly associated with weight (P = 0.033), but was independent of family history of hypertension. BP recordings, both systolic and diastolic, in the study subjects were within normal range. MA occurs significantly enough in children with SCA to warrant routine screening for it. Such a measure could assist in the early detection of ensuing renal complications and can pave way for improved management of a sickler who is particularly prone to such problems. In addition, interventional measures, known to retard rate of deterioration of kidney function due to prolonged proteinuria, could also be instituted early.

摘要

微量白蛋白尿(MA)是影响肾脏系统的各种疾病的早期标志物。其在已知易患肾脏并发症的镰状细胞贫血(SCA)患儿中的相关性尚未得到充分研究,尤其是在本研究地区。此外,在SCA负担巨大的地区,该组患者中MA的发生率仍报告不足。为了评估该队列中MA的患病率,连续纳入并评估了69名年龄在1至16岁之间处于稳定状态的镰状细胞贫血患儿。该研究于2006年11月至2007年2月进行,为横断面描述性研究。采用半定量方法测定每个受试者清晨随机尿样中的MA。还评估了人体测量指标、血压(BP)和血细胞比容。研究对象中MA的患病率为20.3%。虽然无统计学意义,但MA在女性中的患病率(25.9%)高于男性(16.7%)。MA的患病率随年龄增长而增加,并且与体重也显著相关(P = 0.033),但与高血压家族史无关。研究对象的收缩压和舒张压记录均在正常范围内。SCA患儿中MA的发生率显著,足以进行常规筛查。这样的措施有助于早期发现随之而来的肾脏并发症,并可为特别容易出现此类问题的镰状细胞贫血患者改善管理铺平道路。此外,已知可延缓因长期蛋白尿导致的肾功能恶化速度的干预措施也可尽早实施。

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