Prevalence, prevention, and treatment of microalbuminuria and proteinuria in children with sickle cell disease

Kathleen T McKie, Coral D. Hanevold, Caterina M. Hernandez, Jennifer L Waller, Luis A Ortiz, Kathleen M. McKie

Research output: Contribution to journalArticle

76 Scopus citations

Abstract

Microalbuminuria (MA) and proteinuria (P) are believed to be precursors of sickle cell nephropathy. We analyzed our longitudinal data on MA/P in children with sickle cell disease (SS) to define the age of onset, association with age, sex, and hemoglobin, and to explore the safety and efficacy of hydroxyurea and angiotensin converting enzyme inhibitor (ACEI) therapy. Data on 191 patients with SS (ages 3 to 20 y) with a mean follow up of 2.19 years±2.05 were available. Urine MA was measured yearly with follow-up testing if abnormal. Prevalence of MA/P was 19.4%. Increasing age and lower hemoglobin levels were related to MA/P but sex was not. Microalbumin excretion normalized in 44% of patients treated with hydroxyurea and 56% of patients treated with ACEI. Hyperkalemia developed in 4 ACEI patients resulting in discontinuation of treatment in 3 children. In summary, MA/P often develops in childhood and preventive and treatment strategies for sickle cell nephropathy should be a focus of pediatric programs. Our preliminary data suggest that although both hydroxyurea and ACEI therapy may be beneficial for MA/P, hyperkalemia may limit the utility of ACEI.

Original languageEnglish (US)
Pages (from-to)140-144
Number of pages5
JournalJournal of Pediatric Hematology/Oncology
Volume29
Issue number3
DOIs
StatePublished - Mar 1 2007

Keywords

  • ACE inhibitor
  • Hydroxyurea
  • Microalbuminuria
  • Proteinuria
  • Sickle cell disease

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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