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. 2021 Jun;88(6):562-567.
doi: 10.1007/s12098-020-03558-8. Epub 2020 Nov 11.

Abnormal Ambulatory Blood Pressure and Early Renal Dysfunction in Sickle Cell Disease

Shiv Ram Krishna Dubey  1   2 , Neha Shrivastava  1   3 , Tanya Sharma  4 , Girish C Bhatt  5 , Bhavna Dhingra  1 , Abhijit P Pakhare  6 , S K Goel  7 , Deepti Joshi  4
Affiliations

Abnormal Ambulatory Blood Pressure and Early Renal Dysfunction in Sickle Cell Disease

Shiv Ram Krishna Dubey et al. Indian J Pediatr. 2021 Jun.

Abstract

Objectives: There is sparsity of studies evaluating blood pressure in children with sickle cell disease (SCD), which have shown inconsistent results. Few of the studies have documented lower office blood pressure (BP) in SCD patients, whereas, others have shown presence of masked hypertension and abnormal ambulatory blood BP monitoring (ABPM). Thus, the present study was conducted to examine 24 h ABPM parameters and renal dysfunction in children with SCD and compare them with healthy controls.

Methods: A cross-sectional study was conducted on 56 children (30 children having SCD and 26 controls). ABPM and evaluation of renal functions including serum creatinine, serum urea, urinary creatinine, urinary protein and specific gravity was performed.

Results: Spot urinary protein to creatinine ratio was found to be higher in patients with SCD (63.3%) as compared to controls (p < 0.001). Proteinuria was observed in 1/4th of the SCD patients less than ten years of age. Masked hypertension was present in 2 (6.6%) patients, ambulatory hypertension in 4 (13.3%), ambulatory pre-hypertension in 1 (3.3%) and abnormal dipping in 60%. A statistically significant correlation of BMI for age Z-score and standard deviation score (SDS/Z) of 24 h systolic BP (r = 0.56, p = 0.002); estimated glomerular filtration rate (eGFR) with 24 h diastolic BP SDS (r = -0.52; p = 0.038) and age with e GFR (r = 0.54; p = 0.025) was found in the present study.

Conclusions: The present study corroborates that ABPM abnormalities (ambulatory hypertension, non-dipping pattern, ambulatory prehypertension) and early onset proteinuria are significant findings in patients with SCD. This underscores the importance of regular screening for proteinuria and ABPM in routine care, for early detection and prevention of progressive renal damage in SCD.

Keywords: Ambulatory blood pressure monitoring; Renal dysfunction; Sickle cell disease.

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References

    1. Benneh-Akwasi Kuma A, Owusu-Ansah AT, Ampomah MA, et al. Prevalence of relative systemic hypertension in adults with sickle cell disease in Ghana. PLoS One. 2018;13:e0190347.
    1. Gladwin MT. Cardiovascular complications in patients with sickle cell disease. Hematol Am Soc Hematol Educ Program. 2017;2017:423–30. - DOI
    1. Osegbe DN. Haematuria and sickle cell disease. A report of 12 cases and review of the literature. Trop Geogr Med. 1990;42:22–7. - PubMed
    1. Oster JR, Lespier LE, Lee SM, Pellegrini EL, Vaamonde CA. Renal acidification in sickle-cell disease. J Lab Clin Med. 1976;88:389–401. - PubMed
    1. Shatat IF, Jakson SM, Blue AE, Johnson MA, Orak JK, Kalpatthi R. Masked hypertension is prevalent in children with sickle cell disease: a Midwest Pediatric Nephrology Consortium Study. Pediatr Nephrol Berl Ger. 2013;28:115–20.

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