Urine albumin/creatinine ratio: a reliable marker of renal injury in sickle cell nephropathy

Objective: Albumin/creatinine ratio is a sensitive marker of glomerular damage in patients with diabetes mellitus, hypertension and post-infection glomerulonephritis. Whether or not the albumin/creatinine ratio has the same value in sickle cell anemia [SCA] patients is not yet explored. This study was conducted to determine the prevalence of glomerular damage in SCA and the clinical correlation between albumin/creatinine ratio and renal insufficiency in this group of patients

Materials and Methods: Seventy-nine adult patients with SCA [hemoglobin SS subtype] were included in this study. Albumin excretion rates [expressed as albumin/creatinine ratio] and renal function [creatinine clearance] were determined and clinical and hematologic evaluations were conducted

Results: Increased albumin/creatinine ratio [micro- and macroalbuminuria] occurred in 57% of the patients. The development of graded albuminuria was time dependent; therefore, at the end of the study, 26.6% of the patients had macroalbuminuria. There were no differences in hemoglobin levels between patients with normoalbuminuria and those with micro- or macroalbuminuria. By multivariate analysis, albuminuria correlated with age and creatinine clearance [Cr Cl] but not with blood pressure [BP] or hemoglobin levels

Conclusion: Albumin/creatinine ratio is a sensitive marker of glomerular damage in SCA patients, and it correlated well with Cr Cl; therefore, patients with abnormal albumin/creatinine ratio should be monitored closely for progression of renal disease. The development of micro- and macroalbuminuria is related to age but not to the degree of anemia, suggesting that sickle cell glomerulopathy is not solely related to hemodynamic adaptations to chronic anemia

Transport characteristics of patients on automated peritoneal dialysis may not affect their lipid profile

Introduction: End-stage renal disease patients undergoing peritoneal dialysis usually have significant hyperlipidemia. The peritoneal membrane permeability and residual renal function [RRF] may affect lipid profile in these patients

Objective: To study the correlation of lipid profile with peritoneal membrane transport characteristic and RRF as well as cancer antigen [CA]-125 in patients on automated peritoneal dialysis [APD]

Materials and Methods: The present study is a retrospective analysis of forty end-stage renal disease patients on APD. Lipid profile [total cholesterol, serum triglyceride, low-density lipoprotein and high-density lipoprotein], serum albumin and CA-125 were correlated with various peritoneal membrane transporters, assessed by peritoneal equilibration test [PET]. Lipid profile was also correlated with residual renal function and KT/V

Results: The study included 21 female and 19 male patients on APD. The duration of peritoneal dialysis was 18-70 months. There was no significant difference in lipid profile at baseline and at one year in patients with different peritoneal transporter status. There was no correlation between lipid profile and residual renal function as well as CA-125

Conclusion: The findings suggest that there is no relation of lipid profile with peritoneal membrane transporter status and residual renal function in patients maintained on automated peritoneal dialysis