尼日利亚东北部一家三级医院就诊的镰状细胞贫血（HbSS）患者中的蛋白尿和非蛋白尿性慢性肾脏病。

Proteinuric and nonproteinuric chronic kidney disease among patients with sickle cell anaemia (HbSS) attending a tertiary hospital in north-eastern Nigeria.

机构信息

Nephrology Unit, Department of Medicine, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria; Department of Medicine, Faculty of Clinical Sciences, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.

Department of Haematology and Blood Transfusion, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria; Department of Haematology and Blood Transfusion, Faculty of Basic Clinical Sciences, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.

出版信息

Hematol Oncol Stem Cell Ther. 2021 Sep;14(3):214-217. doi: 10.1016/j.hemonc.2020.09.003. Epub 2020 Oct 8.

DOI:10.1016/j.hemonc.2020.09.003

PMID:33065100

Abstract

OBJECTIVE/BACKGROUND: Individuals with sickle cell anaemia (SCA) may manifest various forms of renal abnormalities. Proteinuria is an early marker of renal dysfunction and a strong risk factor for chronic kidney disease (CKD) progression in both patients with SCA and non-SCA population. Currently, the degree of attention given to proteinuric CKD far exceeds that of nonproteinuric CKD, and risk factors that might trigger a progressive decline of the glomerular filtration rate (GFR) in the absence of proteinuria have not been well evaluated in SCA. The aim of this study was to compare the clinical and laboratory parameters among SCA patients with proteinuric and nonproteinuric CKD.

METHODS

This was a cross-sectional study conducted at the University of Maiduguri Teaching Hospital in north-eastern Nigeria between January 2013 and April 2018. Clinical variables including age of diagnosis of SCA, frequency of vaso-occlusive crises, number of hospitalizations per annum and transfusion therapy were collected. Laboratory data including haematological profile and renal function test were obtained from routine blood sampling.

RESULTS

A total of 257 patients with SCA (HbSS) were enrolled during the study period of which 42 had proteinuric CKD, and 48 had nonproteinuric CKD. The two groups were matched for the number of hospital admission (p = .063) and blood transfusion per year (p = .450), frequency of painful crisis (p = .210), systolic blood pressure (p = .084) and diastolic blood pressure (p = .400). In the proteinuric CKD group, the mean serum creatinine was higher (332.17 µmol/L, p = .001) and the estimated GFR was lower (31.88 mL/min, p = .046). The serum alkaline phosphatase was higher in the nonproteinuric CKD group (81.81 IU/L, p = .012).

CONCLUSION

Nonproteinuric CKD was more frequent than proteinuric CKD in our study population; however, the proteinuric group presented with more advanced disease.

摘要

目的/背景：镰状细胞贫血（SCA）患者可能表现出各种形式的肾脏异常。蛋白尿是肾功能障碍的早期标志物，也是 SCA 患者和非 SCA 人群慢性肾脏病（CKD）进展的强危险因素。目前，人们对蛋白尿性 CKD 的重视程度远远超过非蛋白尿性 CKD，而且在 SCA 中，尚未很好地评估那些可能在没有蛋白尿的情况下导致肾小球滤过率（GFR）进行性下降的危险因素。本研究旨在比较蛋白尿性和非蛋白尿性 CKD 的 SCA 患者的临床和实验室参数。

方法

这是 2013 年 1 月至 2018 年 4 月在尼日利亚东北部迈杜古里教学医院进行的一项横断面研究。收集了临床变量，包括 SCA 的诊断年龄、血管阻塞性危象的频率、每年住院次数和输血治疗。实验室数据包括血常规和肾功能检查，从常规血液样本中获得。

结果

在研究期间共纳入 257 例 SCA（HbSS）患者，其中 42 例患有蛋白尿性 CKD，48 例患有非蛋白尿性 CKD。两组的住院人数（p=0.063）和每年输血次数（p=0.450）、疼痛危机频率（p=0.210）、收缩压（p=0.084）和舒张压（p=0.400）均匹配。在蛋白尿性 CKD 组，血清肌酐平均值较高（332.17µmol/L，p=0.001），估计肾小球滤过率较低（31.88mL/min，p=0.046）。非蛋白尿性 CKD 组血清碱性磷酸酶较高（81.81IU/L，p=0.012）。