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. 2020 Jan 31;1(2):79-85.
doi: 10.34067/KID.0000142019. eCollection 2020 Feb 27.

Association between Endothelial Dysfunction, Biomarkers of Renal Function, and Disease Severity in Sickle Cell Disease

Oluwagbemiga Oluwole Ayoola  1   2 , Rahman Ayodele Bolarinwa  3 , Chidiogo Chukwunweike Onwuka  2 , Bukunmi Michael Idowu  4 , Adeniyi Sunday Aderibigbe  1   2
Affiliations

Association between Endothelial Dysfunction, Biomarkers of Renal Function, and Disease Severity in Sickle Cell Disease

Oluwagbemiga Oluwole Ayoola et al. Kidney360. .

Abstract

Background: Endothelial dysfunction (ED), as ascertained by brachial artery flow-mediated dilation (FMD), is a known feature of sickle cell disease (SCD), which is present both in crisis and in steady state. The assessment of FMD was introduced to examine the vasodilator function. Our objective was to establish the relationship between ED determined by FMD, biomarkers of renal dysfunction, and biomarkers of disease severity in SCD subjects asymptomatic of renal disease.

Methods: We enrolled 44 patients with homozygous SCD in steady state and 33 age- and sex-matched controls between 2013 and 2014 in a tropical tertiary hospital. Ultrasonographic FMD of the right brachial artery, renal arterial Doppler, complete blood count, creatinine, fetal hemoglobin, soluble P-selectin, and cystatin C (Cys-C) levels were determined. Using the median FMD value of the control group, the SCD subjects were further classified into two groups for comparison.

Results: The median FMD in SCD subjects of 3.44 (IQR, 0.00-7.08) was significantly lower than that of controls, which was 5.35 (IQR, 3.60-6.78; P=0.04). There was negative correlation between FMD and Cys-C levels (r=-0.372; P=0.01) along with renal artery resistivity index (RARI; r=-0.307; P=0.04) in SCD subjects. Additionally, Cys-C level was significantly higher in SCD subjects with FMD<5.35.

Conclusions: Brachial artery FMD was significantly lower in SCD subjects compared with a control group. Cys-C and RARI show a negative correlation with FMD, indicating that renal function is related to ED in SCD.

Keywords: Anemia Sickle Cell; Biomarkers; Brachial artery; CST3 protein, human; Clinical Nephrology; Creatinine; Cystatin C; Endothelial dysfunction; Fetal Hemoglobin; Flow mediated dilatation; P-Selectin; Renal artery resistivity index; Renal function; Sickle Nephropathy; Tertiary Care Centers.

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Conflict of interest statement

A. Aderibigbe, O. Ayoola, R. Bolarinwa, B. Idowu, and C. Onwuka have nothing to disclose.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Clustered box plot showing the distribution of cystatin C (Cys-C) levels in subjects with sickle cell disease (SCD) on the basis of the flow-mediated dilation (FMD) category and the urine albumin-to-creatinine ratio (UACR) category. Higher levels of Cys-C were shown in those with FMD <5.35 in the 3 UACR categories.
Figure 2.
Figure 2.
A chart showing the relationship between renal impairment and sickle cell disease pathophysiologic processes.
See this image and copyright information in PMC

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