1. Risk factors for <scp>CKD</scp> stage <scp>II</scp> onset in a prospective cohort of homozygous sickle cell adults
- Author
-
V. Avellino, Olivier Steichen, Nadjib Hammoudi, Marine Livrozet, S. Mattioni, Camille Roger, François Lionnet, Jean-Philippe Haymann, Emmanuel Letavernier, CIC - HEGP (CIC 1418), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)
- Subjects
Adult ,Male ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Blood Pressure ,Anemia, Sickle Cell ,urologic and male genital diseases ,Sickle cell nephropathy ,Young Adult ,Risk Factors ,Internal medicine ,medicine ,Albuminuria ,Humans ,Prospective Studies ,Renal Insufficiency, Chronic ,Risk factor ,Prospective cohort study ,ComputingMilieux_MISCELLANEOUS ,Proportional Hazards Models ,business.industry ,Incidence ,Age Factors ,Hematology ,medicine.disease ,Sickle cell anemia ,Blood pressure ,Cohort ,Female ,Microalbuminuria ,business ,Glomerular Filtration Rate ,Cohort study - Abstract
Prevalence of renal impairment is increasing with aging in sickle cell anemia (SCA) patients responsible for a high morbidity and mortality. However, sickle cell nephropathy natural course remains mostly unknown. We conducted a prospective observational cohort study aimed to identify risk factors for CKD stage II in a cohort of SCA patients. Baseline clinical and biological parameters were collected. Renal parameters were updated at each visit. Risk factors were analyzed using Cox model. 535 SCA patients were included with a median follow-up of 5.33 (IQR:2.10-8.13) years. Median age was 22 (IQR:19-30) years old. Glomerular hyperfiltration was detected in 299 (55.9%) patients, microalbuminuria and macroalbuminuria in 180 (34%) and 67 (12.7%) patients respectively. During follow up, CKD stage II onset was detected in 39 patients (7.3%). Risk factors for CKD stage II after adjustment on baseline eGFR and age were macroalbuminuria HR: 3.89 [95% CI: 1.61;9.43], diastolic blood pressure (DBP) above 70 mmHg HR: 2.02 [1.02-3.971], LDH (for 100 UI/L increase) HR: 1.28 [1.12;1.48] and tricuspid regurgitation velocity >2.5 m/sec HR: 2.89 [1.20- 6.99]. Multivariate analysis also found age as a strong independent risk factor with HR: (per year increase) 1.13 [1.09;1.16] and a 13.3 fold increase above 30 years (p
- Published
- 2021
- Full Text
- View/download PDF