Author(s)

Nosakhare Joyce Iduoriyekemwen^1,2*, Caroline Booth³, Marilyn McDougall⁴, Psalm Duniya Baba Inusa⁵

¹Advance Paediatric Masters Programme, King’s College London, London, UK.
²Paediatric Nephrology Unit, Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria.
³Department of Paediatric Nephrology, Evelina Children Hospital, London, UK.
⁴Department of Paediatric Critical Care, Evelina Children Hospital, London, UK.
⁵Department of Paediatric Haematology, Evelina Children Hospital, London, UK.

Background: Sickle Cell Disease (SCD) renal abnormalities commence early in childhood. The glomerular abnormalities, glomerular hyperfiltration and albuminuria are the most prevalent. However, these SCD glomerulopathies have not been considered exclusively in the adolescent age group. Objective: To determine the prevalence of glomerular hyperfiltration and albuminuria as well as identify the determinants for glomerular hyperfiltration in adolescents with SCD. Patients and Methods: The electronic patient records of 153 adolescents with SCD aged 10 - <19 years, attending the Paediatrics Haematology Clinic at Evelina London Children’s Hospital, United Kingdom, were reviewed from the 10^th to 23^rd June 2019. Clinical information and laboratory parameters were obtained. The glomerular filtration rate was derived using the Bedside Schwartz’s method. Grouping of the adolescents was based on the presence and absence of glomerular hyperfiltration, which was defined as glomerular filtration rate > 140 ml/min/m². The presence of albuminuria was defined as urine albumin-to-creatinine ratio > 3 mg/mmol or protein-to-creatinine ratio of >15 mg/mmol. The clinical and laboratory determinants of glomerular hyperfiltration in the total study population were investigated. Result: Prevalence of glomerular hyperfiltration was 33.3% in the adolescents studied, and that of albuminuria was 15.7% amongst the SCD adolescents studied, of which 13.7% of those with glomerular hyperfiltration also had albuminuria. On univariable analysis, the SCD adolescents with glomerular hyperfiltration had significantly lower weight (48.0 ± 18.0 versus 54.8 ± 17.0 kg; p = 0.02), height (155.1 ± 13.1 versus 160.6 ± 13.1 cm; p = 0.01), body mass index (19.4 ± 5.0 versus 21.0 ± 4.3; p = 0.04), haemoglobin level (88.7 ± 13.3 versus 98.1 ± 21.7 g/L; p = 0.001), and serum creatinine level (0.4 ± 0.1 versus 0.6 ± 0.2 mg/dl; p = 0.0001) as compared to those with no glomerular hyperfiltration. The SCD adolescents with glomerular hyperfiltration also had significantly higher lactate dehydrogenase levels (525.9 ± 180.3 versus 449.6 ± 170.3 IU/L; p = 0.01) than those with no glomerular hyperfiltration. But, multivariable analysis revealed no associations. Conclusion: This study revealed that the prevalence of glomerular hyperfiltration in SCD children in the adolescent age group is high, and the high glomerular filtration rates begin to decline toward normal values in middle adolescence.

Glomerular Hyperfiltration, Albuminuria, Sickle Cell Disease, Adolescent

Iduoriyekemwen, N. , Booth, C. , McDougall, M. and Inusa, P. (2021) Evaluation of Glomerular Hyperfiltration and Albuminuria in Sickle Cell Disease Adolescents: Cross-Sectional Retrospective Study. Open Journal of Nephrology, 11, 321-334. doi: 10.4236/ojneph.2021.113026.