Rapid decline in estimated glomerular filtration rate is common in adults with sickle cell disease and associated with increased mortality.
Vimal K DerebailQingning ZhouEmily J CicconeJianwen CaiKenneth I AtagaPublished in: British journal of haematology (2019)
We evaluated the prevalence of rapid decline in kidney function, its potential risk factors and influence upon mortality in sickle cell disease (SCD) in a retrospective single-center study. Rapid decline of kidney function was defined as estimated glomerular filtration rate (eGFR) loss of >3·0 ml/min/1·73 m2 per year. A multivariable logistic regression model for rapid eGFR decline was constructed after evaluating individual covariates. We constructed multivariate Cox-regression models for rapid eGFR decline and mortality. Among 331 SCD patients (median age 29 years [interquartile range, IQR: 20, 41]; 187 [56·5%] female) followed for median 4·01 years (IQR: 1·66, 7·19), rapid eGFR decline was noted in 103 (31·1%). History of stroke (odds ratio [OR]: 2·91, 95% confidence interval [CI]: 1·25-6·77) and use of angiotensin converting enzyme inhibitors/angiotensin receptor blockers (OR: 3·17, 95% CI: 1·28-7·84) were associated with rapid eGFR decline. The rate of eGFR change over time was associated with mortality (hazard ratio [HR]: 0·99, 95% CI: 0·984-0·995, P = 0·0002). In Cox-regression, rapid eGFR decline associated with mortality (HR: 2·07, 95% CI: 1·039-4·138, P = 0·04) adjusting for age, sex and history of stroke. Rapid eGFR decline is common in SCD and associated with increased mortality. Long-term studies are needed to determine whether attenuating loss of kidney function may decrease mortality in SCD.
Keyphrases
- small cell lung cancer
- risk factors
- epidermal growth factor receptor
- tyrosine kinase
- cardiovascular events
- loop mediated isothermal amplification
- angiotensin converting enzyme
- sickle cell disease
- angiotensin ii
- atrial fibrillation
- cardiovascular disease
- type diabetes
- newly diagnosed
- ejection fraction
- chronic kidney disease
- binding protein
- sensitive detection
- blood brain barrier
- patient reported outcomes