Assessment of renal function in Indian patients with sickle cell disease

Abstract EN

Sickle cell disease (SCD) and its variants are genetic disorders resulting from the presence of a mutated form of hemoglobin.

Renal disease is one of the most frequent complications, and kidney damage starts very early and progresses throughout life causing severe complications.

The present study is aimed to analyze creatinine-based estimated glomerular filtration rate (eGFR) in 616 SCD patients (507 HbSS and 109 HbSB+), receiving medical care at outpatient wing of Sickle Cell Institute, Chhattisgarh.

Glomerular filtration rate (GFR) estimated using the Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault, chronic kidney disease epidemiology collaboration (CKD-EPI) (<17 years analyzed with Schwartz), and SCD specific Jamaica Sickle Cell Cohort Study (JSCCS)-GFR equations were compared.

Further, eGFR calculated using the CKD-EPI and Schwartz equations was used to define various stages of kidney function and compared with clinical and hematological variables.

The mean age of patients was 15.8 years.

Comparison of eGFR using various formulas revealed that MDRD and JSCCS formulas overestimated the GFR.

Among SCD patients, prevalence of glomerular hyperfiltration (GHF) is high followed by renal insufficiency (RI) and renal failure (RF).

However, no differences were found in hematological profiling among different functional stages of kidney.

Age and body surface area are significantly more in SCD individuals with normal kidney function and GHF.

Participants with RF showed a higher level of blood urea and fetal hemoglobin.

In summary, this is the first study to analyze different functional stages of kidney among SCD patients of India.

Our study revealed that the GHF and RI are the important indicators of kidney damage.