Abdel Hakeem Gehan Lotfy, Abdel Naeem Emad Allam, Swelam Salwa Hussein, El Morsi Aboul Fotoh Laila, El Mazary Abdel Azeem Mohamed, Abdel Fadil Ashraf Mohamed, Abdel Hafez Asmaa Hosny
Pediatric Department, Minia University, Egypt.
Clinical Pathology Department, Minia University, Egypt.
Mediterr J Hematol Infect Dis. 2016 Aug 20;8(1):e2016038. doi: 10.4084/MJHID.2016.038. eCollection 2016.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency anemia is associated with intravascular hemolysis. The freely filtered hemoglobin can damage the kidney. We aimed to assess any subclinical renal injury in G6PD children.
Sixty children were included. Thirty G6PD deficiency anemia children were enrolled during the acute hemolytic crisis and after the hemolytic episode had elapsed. Another thirty healthy children were included as controls. Serum cystatin C, creatinine levels, and urinary albumin/creatinine (A/C) ratio were measured, and the glomerular filtration rate (GFR) was calculated.
Significantly higher urinary A/C ratio (p=0.001,0.002 respectively) and lower GFR (p=0.001 for both) were found during hemolysis and after the hemolytic episode compared to the controls. Also, significant higher serum cystatin C (p=0.001), creatinine (p=0.05) and A/C (p= 0.001) ratio and insignificant lower GFR (p=0.3) during acute hemolytic crisis compared to the same children after the hemolytic episode subsided.
G6PD deficiency anemia is associated with a variable degree of acute renal injury during acute hemolytic episodes which may persist after elapsing of the hemolytic crises.
葡萄糖-6-磷酸脱氢酶（G6PD）缺乏性贫血与血管内溶血有关。自由滤过的血红蛋白会损害肾脏。我们旨在评估G6PD缺乏儿童是否存在亚临床肾损伤。
纳入60名儿童。30名G6PD缺乏性贫血儿童在急性溶血危机期间及溶血发作结束后入组。另外30名健康儿童作为对照。测量血清胱抑素C、肌酐水平和尿白蛋白/肌酐（A/C）比值，并计算肾小球滤过率（GFR）。
与对照组相比，在溶血期间及溶血发作后，尿A/C比值显著升高（分别为p=0.001,0.002），GFR显著降低（两者均为p=0.001）。此外，与溶血发作消退后的同一儿童相比，急性溶血危机期间血清胱抑素C显著升高（p=0.001）、肌酐（p=0.05）和A/C（p=0.001）比值升高，GFR降低不显著（p=0.3）。
G6PD缺乏性贫血与急性溶血发作期间不同程度的急性肾损伤有关，这种损伤在溶血危机消退后可能持续存在。
