Renal function in infants with sickle cell anemia: baseline data from the BABY HUG trial
Russell E Ware, Renee C Rees, Sharada A Sarnaik, Rathi V Iyer, Ofelia A Alvarez, James F Casella, Barry L Shulkin, Eglal Shalaby-Rana, C Frederic Strife, John H Miller, Peter A Lane, Winfred C Wang, Scott T Miller, BABY HUG Investigators, Catherine Driscoll, Caterina Minniti, Lori Luchtman-Jones, Brenda Martin, Barbara Speller-Brown, Courtney Thornburg, Sherri Zimmerman, William Schultz, Tracy Kelly, Jacqueline Davis, Sohail Rana, Caroline K Reed, Jhoanna Jhoanna Roa, Patricia Houston, Erin Yeagley, Phillip Seaman, Jeffrey Keefer, Sue Dixon, Melvin J Reinhardt, M Robert De Jong, Ram Kalpatthi, Sherron Jackson, Betsy Rackoff, Lisa Kuisel, Deborah Disco, Lane Faughnan, Lynn Wynn, Kathy Rey, Rebecca S Gonzalez, Arnold M Strashun, Julio Barredo, Stuart Toledano, Tally Hustace, Glenda Thomas, Deborah Estess, Freida McKenzie, Mary Gail Smith, Tom Hogan, Zora R Rogers, Cindy Cochran, Jennifer Marshall, Leah Adix, Thomas Howard, Jennifer McDuffie, Roy McDonald, Kim Whelan, Lori Luck, Mary Lou MacDermott, R Clark Brown, Ifeyinwa Osunkwo, Anne Herry, Eldrida Randall, Korin Cherry, Sharada Sarniak, Wanda Whitten-Shurney, Mary Murphy, Rana Khatib, Bruce Thompson, Daner Li, Xiangke Huang, Russell E Ware, Renee C Rees, Sharada A Sarnaik, Rathi V Iyer, Ofelia A Alvarez, James F Casella, Barry L Shulkin, Eglal Shalaby-Rana, C Frederic Strife, John H Miller, Peter A Lane, Winfred C Wang, Scott T Miller, BABY HUG Investigators, Catherine Driscoll, Caterina Minniti, Lori Luchtman-Jones, Brenda Martin, Barbara Speller-Brown, Courtney Thornburg, Sherri Zimmerman, William Schultz, Tracy Kelly, Jacqueline Davis, Sohail Rana, Caroline K Reed, Jhoanna Jhoanna Roa, Patricia Houston, Erin Yeagley, Phillip Seaman, Jeffrey Keefer, Sue Dixon, Melvin J Reinhardt, M Robert De Jong, Ram Kalpatthi, Sherron Jackson, Betsy Rackoff, Lisa Kuisel, Deborah Disco, Lane Faughnan, Lynn Wynn, Kathy Rey, Rebecca S Gonzalez, Arnold M Strashun, Julio Barredo, Stuart Toledano, Tally Hustace, Glenda Thomas, Deborah Estess, Freida McKenzie, Mary Gail Smith, Tom Hogan, Zora R Rogers, Cindy Cochran, Jennifer Marshall, Leah Adix, Thomas Howard, Jennifer McDuffie, Roy McDonald, Kim Whelan, Lori Luck, Mary Lou MacDermott, R Clark Brown, Ifeyinwa Osunkwo, Anne Herry, Eldrida Randall, Korin Cherry, Sharada Sarniak, Wanda Whitten-Shurney, Mary Murphy, Rana Khatib, Bruce Thompson, Daner Li, Xiangke Huang
Abstract
Objectives: To examine the feasibility and accuracy of glomerular filtration rate (GFR) measurements in infants with sickle cell anemia (SCA).
Study design: The NHLBI/NICHD-sponsored Phase III randomized double-blinded placebo-controlled trial (BABY HUG) tests the hypothesis that hydroxyurea can prevent chronic organ damage in SCA. GFR elevation is a coprimary endpoint, measured quantitatively by technetium 99m-labeled diethylenetriaminepentaacetic acid (DTPA) plasma clearance and estimated by the Schwartz equation with height and creatinine.
Results: Baseline DTPA GFR measurement was attempted in 191 infants; 176 of 184 completed studies (96%) were interpretable. Average age (mean +/- 1SD) was 13.7 +/- 2.6 months. Average DTPA GFR was 125.2 +/- 34.4 (range 40.2-300.9, normal 91.5 +/- 17.8 mL/min/1.73m(2)), while Schwartz estimates were higher at 184.4 +/- 55.5 mL/min/1.73m(2). DTPA GFR was correlated with Schwartz GFR (r(2) = 0.0658, P = .0012); also with age, weight, height, and kidney volume (all P < .002); but not with hemoglobin, HbF, white blood cell count, reticulocytes, medical events, or splenic function.
Conclusions: Quantitative GFR measurement is feasible but variable among infants with SCA. Schwartz GFR estimates are not highly correlated with quantitative DTPA GFR values. Baseline GFR measurements suggest that renal dysfunction in SCA, evidenced by glomerular hyperfiltration, begins during infancy.
Conflict of interest statement
The authors declare no conflicts of interest.
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Source: PubMed