Sickle cell trait, estimated glomerular filtration rate, and risk of adverse outcomes in chronic kidney disease.
Sickle cell trait, estimated glomerular filtration rate, and risk of adverse outcomes in chronic kidney disease.
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镰状细胞性状、估计肾小球滤过率以及慢性肾脏病不良后果的风险。
DOI：
10.1002/ajh.25588
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发表时间：
2019
影响因子：
12.8
通讯作者：
Naik,RakhiP
中科院分区：
文献类型：
--
作者：
Sood,Rupali;Surapaneni,Aditya;Luo,Shengyuan;Appel,LawrenceJ;Winkler,Cheryl;Grams,MorganE;Naik,RakhiP
最近的证据表明，镰状细胞性状（SCT），定义为镰状血红蛋白的杂合遗传，与流行和偶发慢性肾脏疾病（CKD）的风险增加有关。1，2然而，关于SCT是否与其他相关结局的风险增加相关的证据有限，包括心血管疾病（CVD），CKD进展，终末期肾病（ESKD）和确诊CKD患者的死亡。1确定这些结果的风险很重要，因为肾脏护理、血管通路和移植的转诊主要基于不良结果的概率。CKD和SCT研究的另一个复杂方面是，由于非GFR决定因素，血清肌酐作为滤过标志物可能不能很好地反映镰状细胞性贫血患者的真实GFR; 3然而，肌酐在SCT中的表现尚不清楚。在非裔美国人肾脏疾病和高血压研究（AASK）的参与者中，我们评估了125 I-碘酞酸盐（mGFR）测量的GFR与基于肌酐的GFR估计值相比的准确性和精密度。
Recent evidence suggests that sickle cell trait (SCT), defined as the heterozygous inheritance of sickle hemoglobin, is associated with an increased risk of prevalent and incident chronic kidney disease (CKD). 1, 2 However, there is limited evidence as to whether SCT is associated with an increased risk of other relevant outcomes, including cardiovascular disease (CVD), CKD progression, end-stage kidney disease (ESKD), and death among those with established CKD. 1 Determining risk for these outcomes is important since referrals for nephrology care, vascular access, and transplant are largely based on the probability of adverse outcomes. Another complicating aspect of the study of CKD and SCT is the concern that serum creatinine as a filtration marker may poorly reflect true GFR for patients with sickle cell anemia due to non-GFR determinants; 3 however, the performance of creatinine in SCT is unknown. Among participants in the African American Study of Kidney Disease and Hypertension (AASK) study, a well-characterized cohort of individuals with hypertensionattributed CKD followed for a median of 10 years, we evaluated the accuracy and precision of GFR measured by 125I-iothalamate (mGFR) compared to creatinine-based GFR estimates