Evaluation of Renal Arterial Resistivity Index and Some Biochemical Parameters in Sickle Cell Disease: A Preliminary Study for Early Detection of Renal Impairment
Keywords:
urinary albumin-creatinine ratio, serum kidney injury molecule 1, cystatin-C, renal arterial Doppler resistive index, Sickle cell diseaseAbstract
Background: The Doppler Resistive Index (RI) measures intrarenal arterial resistance. It is increased in a number of kidney diseases and considered a marker of renal function, which could serve as an early radiologic predictor of renovascular changes in sickle cell disease (SCD).
Aims and Objective: This study evaluated selected biochemical markers of renal functionand renal Doppler RI in a cohort of Nigerian adults with SCD and Hb AA controls.
Materials and Methods: Forty-four Hb SS patients in steady state (M:F = 1.2:1; median age is 24.5) and 22 Hb AA age and sex-matched controls were recruited consecutively into the study. All had serum biochemical tests including serum cystatin-C, serum kidney injury molecule-1 and serum creatinine while urinary albumin-creatinine ratio was also evaluated. The right renal artery Doppler RI was also evaluated in the segmental/interlobar arteries while relevant nonparametric tests were used to compare the biochemical and Doppler parameters between the subjects and the controls.
Results: Serum creatinine ranged from subnormal to mildly elevated levels in patients with Hb SS (33245µmol/l) and the median (range) renal arterial Doppler RI was 0.70 (0.49-0.81). The other parameters evaluated were significantly higher in patients relative to the controls. Of the biochemical parameters, urinary albumin- creatinine ratio showed a weak but statistically significant positive correlation with renal arterial Doppler RI (r=0.329; p= 0.029), while serum cystatin-C and kidney injury molecule-1 had no correlation (r = 0.152 and 0.188 respectively; p = 0.324 and 0.22).
Conclusion: Renal arterial Doppler Resistivity Index has a linear relationship with urinary albumin-creatinine ratio and could therefore be a potential marker of early renal impairment in patients with SCD.
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