Proteinuria is associated with elevated tricuspid regurgitant jet velocity in children with sickle cell disease
Proteinuria is associated with elevated tricuspid regurgitant jet velocity in children with sickle cell disease
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DOI：
10.1002/pbc.23338
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发表时间：
2012-06-01
影响因子：
3.2
通讯作者：
Pashankar, Farzana
中科院分区：
文献类型：
--
作者：
Forrest, Suzanne;Kim, Ashley;Pashankar, Farzana
背景 镰状细胞病 (SCD) 影响多个器官系统。 SCD 的并发症，如肺动脉高压 (PHT) 和镰状细胞肾病 (SCN) 与死亡率增加相关。 PHT 和 SCN 都有一些共同的危险因素。在成人中，PHT 被发现与白蛋白尿（SCN 的一种表现）有关。没有关于儿童中这种关联的数据。我们进行了一项研究，以确定超声心动图估计的肺动脉收缩压升高是否与 SCD 儿童的蛋白尿相关。方法。对 2005 年 6 月至 2010 年 7 月期间接受超声心动图筛查的镰状细胞病患者队列进行了详细的回顾性图表审查。纳入了 1 年内接受过超声心动图初筛和尿液分析的患者。收集所有后续超声心动图和尿液分析的纵向数据。结果。包括八十五名患者。初始超声心动图显示，32.9% 的三尖瓣反流射流速度 (TRV) >= 2.5 m/秒升高。随访时，28 例 TRV 升高的患者中，49.27% 的重复超声心动图显示持续升高。在 57 名基线 TRV 正常的患者中，73.6% 的重复超声心动图 TRV 继续正常。初步筛查时，TRV 升高的患者中有 7.14% 患有蛋白尿，而 TRV 不升高的患者为 1.75%。随访时，基线 TRV 升高的患者中有 19.08% 的重复尿液分析出现蛋白尿，而基线 TRV 正常的患者中这一比例为 12.35%（P = 0.04）。结论。在 SCD 儿童的纵向随访中，升高的 TRV >= 2.5 m/s 与蛋白尿显着相关。儿科血癌2012； 58：937-940。（C）2011 年 Wiley 期刊公司。
Background Sickle cell disease (SCD) affects multiple organ systems. Complications of SCD such as pulmonary hypertension (PHT) and sickle cell nephropathy (SCN) are associated with an increased mortality. Both PHT and SCN have some common risk factors. In adults, PHT has been found to be associated with albuminuria, a manifestation of SCN. There is no data on this association in children. We conducted a study to determine if elevated pulmonary artery systolic pressures estimated on echocardiogram was associated with proteinuria in children with SCD. Methods. A detailed retrospective chart review was conducted on a cohort of sickle cell patients screened with echocardiograms from June 2005 to July 2010. Patients who had an initial screening echocardiogram and urine analysis within 1 year were included. Longitudinal data from all subsequent echocardiograms and urine analyses were collected. Results. Eighty- five patients were included. On initial echocardiograms 32.9% had an elevated tricuspid regurgitant jet velocity (TRV) >= 2.5 m/ second. On follow up, in the 28 patients with elevated TRV, 49.27% of all repeat echocardiograms showed persistent elevation. In the 57 patients with normal baseline TRV, 73.6% of all repeat echocardiograms continued to have normal TRV. On initial screening 7.14% of patients with elevated TRV had proteinuria compared to 1.75% without elevated TRV. On follow up, 19.08% of repeat urinalysis had proteinuria in patients with elevated baseline TRV compared to 12.35% in patients with normal baseline TRV (P = 0.04). Conclusions. Elevated TRV >= 2.5 m/second is significantly associated with proteinuria on longitudinal follow up in children with SCD. Pediatr Blood Cancer 2012; 58: 937- 940. (C) 2011 Wiley Periodicals, Inc.