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Pediatric Nephrology

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01-05-2020 | Albuminuria | Original Article

Hyperuricemia is associated with a lower glomerular filtration rate in pediatric sickle cell disease patients

Authors: Cristin D. W. Kaspar, Isidora Beach, Jennifer Newlin, India Sisler, Daniel Feig, Wally Smith

Published in: Pediatric Nephrology | Issue 5/2020

Abstract

Background

Sickle cell nephropathy (SCN) is a progressive disease that contributes significant morbidity and mortality in sickle cell disease (SCD), yet it remains poorly understood. Hyperuricemia negatively impacts renal function in the non-sickle cell population but is understudied in SCD.

Methods

We performed a cross-sectional analysis of the first 78 pediatric SCD patients enrolled in a cohort study. The mechanism of development of hyperuricemia (defined, serum uric acid (UA) ≥ 5.5 mg/dL) was characterized as a result of either UA overproduction or inefficient renal excretion by the Simkin index and fractional clearance of urate (FCU) equations. Associations between hyperuricemia and albuminuria or estimated glomerular filtration rate (eGFR) were determined by linear regression.

Results

The prevalence of hyperuricemia in this young population (mean age 11.6 ± 3.77 years) was 34.2%. Only 1 hyperuricemic participant overproduced UA by Simkin index, while 62.5% were inefficient renal excretors of UA (FCU < 4%). Hyperuricemia was associated with a significant decrease in average eGFR, −27 ml/min/1.73m² below normouricemia (mean eGFR 151.6 ± 40.32), p = 0.0122. Notably, the previously accepted association between decline of eGFR with age is significantly modified by hyperuricemia stratification, where hyperuricemia explains 44% of the variance in eGFR by age (R² = 0.44, p = 0.0004) and is nonsignificant in normouricemia (R² = 0.07, p = 0.0775).

Conclusion

These findings indicate that hyperuricemia may be associated with early eGFR decline in SCN. This association must be further characterized in prospective cohort studies in SCN, and hyperuricemia must be investigated as a potential therapeutic target for SCN.

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Title: Hyperuricemia is associated with a lower glomerular filtration rate in pediatric sickle cell disease patients
Authors: Cristin D. W. Kaspar
Isidora Beach
Jennifer Newlin
India Sisler
Daniel Feig
Wally Smith
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keyword: Albuminuria
Published in: Pediatric Nephrology / Issue 5/2020
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-019-04432-2

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Hyperuricemia is associated with a lower glomerular filtration rate in pediatric sickle cell disease patients

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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