Lactate dehydrogenase as a predictor of kidney involvement in patients with sickle cell anemia
Lactate dehydrogenase as a predictor of kidney involvement in patients with sickle cell anemia
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DOI：
10.1007/s00467-010-1560-8
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发表时间：
2010-10-01
影响因子：
3
通讯作者：
Drachtman, Richard
中科院分区：
文献类型：
--
作者：
Gurkan, Sevgi;Scarponi, Kyla J.;Drachtman, Richard
对40例年龄在5-19岁之间的镰状细胞性贫血（SCA）患者进行回顾性图表回顾，以确定微量白蛋白尿和蛋白尿的临床和实验室相关性。通过单因素和多因素回归分析，年龄、性别、身高、体重指数（BMI）、血清肌酐[以及Schwartz和MDRD公式估算的肾小球滤过率（eGFR）]、SCA类型、血红蛋白（Hb）水平[总Hb和血红蛋白F百分比（HbF%）]、乳酸脱氢酶（LDH）水平、网织红细胞计数、血压、脾切除术史、羟基脲使用史和输血史与微量白蛋白尿和蛋白尿相关。这些患者中微量蛋白尿和蛋白尿的患病率分别为15%和5%。单因素分析显示LDH水平与微量白蛋白尿之间存在显著相关性（Pearson r = 0.47, p= 0.04）， LDH水平与蛋白尿之间存在显著相关性（Pearson r = 0.48, p=0.035）。多因素分析显示，在控制年龄、性别、eGFR、Hb水平、HbF%、SCA类型、BMI、输血史和网状红细胞计数的情况下，微量白蛋白尿和LDH水平之间存在显著相关性（p = 0.04）。在这个儿童SCA人群中，LDH被发现与微量蛋白尿和蛋白尿的存在相关。需要进一步的研究来证实LDH作为SCA患者肾脏受累风险的早期标志物。
A retrospective chart review of 40 patients with sickle cell anemia (SCA) between the ages of 5-19 years who were seen within a 1-year period was performed to determine clinical and laboratory correlates for microalbuminuria and proteinuria. Age, sex, height, body mass index (BMI), serum creatinine [and estimated glomerular filtration rate (eGFR) by Schwartz and MDRD formulas], type of SCA, hemoglobin (Hb) level [total Hb and hemoglobin F percentage (HbF%)], lactate dehydrogenase (LDH) level, reticulocyte count, blood pressure, history of splenectomy, history of hydroxyurea use, and history of transfusions were correlated with microalbuminuria and proteinuria by univariate and multivariate regression analysis. The prevalence of microalbuminuria and proteinuria among these patients was 15 and 5%, respectively. Univariate analyses revealed a significant correlation between LDH level and microalbuminuria (Pearson r = 0.47, p = 0.04) and between LDH level and proteinuria (Pearson r = 0.48, p=0.035). Multivariate analysis revealed a significant correlation between microalbuminuria and LDH level (p = 0.04) when controlled for age, sex, eGFR, Hb level, HbF%, type of SCA, BMI, history of transfusions, and reticulocyte count. In this pediatric SCA population, LDH was found to correlate with the presence of microalbuminuria and proteinuria. Further studies are needed to confirm LDH as an early marker for the risk of kidney involvement among SCA patients.