Nephrin as a biomarker of sickle cell glomerulopathy in Malawi

J. Brett Heimlich, Godwin Chipoka, Laila Elsherif, Emeraghi David, Graham Ellis, Portia Kamthunzi, Robert Krysiak, Pilirani Mafunga, Qingning Zhou, Jianwen Cai, Satish Gopal, Nigel S. Key, Kenneth Ataga

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Glomerulopathy is an increasingly identified complication in young patients with sickle cell disease (SCD). Hyperfiltration and albuminuria followed by declining glomerular filtration rates and eventual end-stage renal disease (ESRD) is assumed to be the typical progression of glomerular disease. There are only a few reported biomarkers to identify early-stage renal disease in SCD. Procedures: We detail the renal profile of 101 children with SCD in Malawi and propose a novel urinary biomarker for the identification of early renal disease. Results: Among children with sickle cell anemia, 24.8% had a urine albumin–creatinine ratio of 30 mg/g or above. In univariate analysis, only patients with higher urinary nephrin, a urinary marker of glomerular injury, had significantly greater odds of having albuminuria. In multivariable analysis, nephrin remained significantly associated with albuminuria. A nephrin–creatinine ratio (NCR) cut-point of 622 ng/mg, the 50 th percentile, was associated with a 45.8 times greater odds of having albuminuria in children with nephrinuria above this value. Further analysis revealed this urinary NCR cut-point to have 96% sensitivity, 64% specificity, 47% positive predictive value, and 98% negative predictive value for the presence of albuminuria. Conclusions: These data suggest that a substantial number of children with SCD in Malawi have renal disease and could be at risk for worsening nephropathy and ESRD as they age. Our data suggest that urinary nephrin could be utilized as an early marker of glomerular disease in SCD.

Original languageEnglish (US)
Article numbere26993
JournalPediatric Blood and Cancer
Volume65
Issue number6
DOIs
StatePublished - Jun 1 2018

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Malawi
Sickle Cell Anemia
Albuminuria
Biomarkers
Kidney
Chronic Kidney Failure
Glomerular Filtration Rate
Disease Progression
nephrin
Urine
Sensitivity and Specificity
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Nephrin as a biomarker of sickle cell glomerulopathy in Malawi. / Heimlich, J. Brett; Chipoka, Godwin; Elsherif, Laila; David, Emeraghi; Ellis, Graham; Kamthunzi, Portia; Krysiak, Robert; Mafunga, Pilirani; Zhou, Qingning; Cai, Jianwen; Gopal, Satish; Key, Nigel S.; Ataga, Kenneth.

In: Pediatric Blood and Cancer, Vol. 65, No. 6, e26993, 01.06.2018.

Research output: Contribution to journalArticle

Heimlich, JB, Chipoka, G, Elsherif, L, David, E, Ellis, G, Kamthunzi, P, Krysiak, R, Mafunga, P, Zhou, Q, Cai, J, Gopal, S, Key, NS & Ataga, K 2018, 'Nephrin as a biomarker of sickle cell glomerulopathy in Malawi', Pediatric Blood and Cancer, vol. 65, no. 6, e26993. https://doi.org/10.1002/pbc.26993
Heimlich JB, Chipoka G, Elsherif L, David E, Ellis G, Kamthunzi P et al. Nephrin as a biomarker of sickle cell glomerulopathy in Malawi. Pediatric Blood and Cancer. 2018 Jun 1;65(6). e26993. https://doi.org/10.1002/pbc.26993
Heimlich, J. Brett ; Chipoka, Godwin ; Elsherif, Laila ; David, Emeraghi ; Ellis, Graham ; Kamthunzi, Portia ; Krysiak, Robert ; Mafunga, Pilirani ; Zhou, Qingning ; Cai, Jianwen ; Gopal, Satish ; Key, Nigel S. ; Ataga, Kenneth. / Nephrin as a biomarker of sickle cell glomerulopathy in Malawi. In: Pediatric Blood and Cancer. 2018 ; Vol. 65, No. 6.
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AU - Ellis, Graham

AU - Kamthunzi, Portia

AU - Krysiak, Robert

AU - Mafunga, Pilirani

AU - Zhou, Qingning

AU - Cai, Jianwen

AU - Gopal, Satish

AU - Key, Nigel S.

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