First evidence of subclinical renal tubular injury during sickle-cell crisis.

Vincent Audard 1, * Stéphane Moutereau 2 Gaetana Vandemelebrouck 3 Anoosha Habibi 4, 5 Mehdi Khellaf 6 Philippe Grimbert 1 Yves Levy 7 Sylvain Loric 2 Bertrand Renaud 6 Philippe Lang 1 Bertrand Godeau 5 Frédéric Galactéros 8 Pablo Bartolucci 8, *
* Auteur correspondant
1 Equipe 21 Inserm
Service de Néphrologie et Transplantation, IMRB - Institut Mondor de Recherche Biomédicale
3 Equipe 2 Inserm
EFS - Etablissement Français du Sang, IMRB - Institut Mondor de Recherche Biomédicale
8 Equipe 2 Inserm
Centre de Référence des Syndromes Drépanocytaires Majeurs, Service de Médecine Interne, IMRB - Institut Mondor de Recherche Biomédicale
Abstract : BACKGROUND: The pathophysiologic mechanisms classically involved in sickle-cell nephropathy include endothelial dysfunction and vascular occlusion. Arguments demonstrating that ischemia-reperfusion injury-related kidney damage might coincide with vaso-occlusive crisis (VOC) are lacking. METHODS: In this prospective study, we sought to determine whether tubular cells and glomerular permeability might be altered during VOC. Urine neutrophil gelatinase-associated lipocalin (NGAL) levels and albumin-excretion rates (AER) of 25 patients were evaluated prospectively during 25 VOC episodes and compared to their steady state (ST) values. RESULTS: During VOC, white blood-cell counts (WBC) and C-reactive protein (CRP) were significantly higher than at ST but creatinine levels were comparable. Urine NGAL levels were significantly increased during VOC vs ST (P = 0.007) and remained significant when normalized to urine creatinine (P = 0.004), while AER did not change significantly. The higher urine NGAL concentration was not associated with subsequent (24-48 hour) acute kidney injury. Univariate analysis identified no significant correlations between urine NGAL levels and laboratory parameters during VOC. CONCLUSIONS: These results demonstrated that subclinical ischemia-reperfusion tubular injury is common during VOC and highlight the importance of hydroelectrolyte monitoring and correction during VOC.
Type de document :
Article dans une revue
Orphanet Journal of Rare Diseases, BioMed Central, 2014, 9 (1), pp.67. 〈10.1186/1750-1172-9-67〉
Liste complète des métadonnées

Littérature citée [23 références]  Voir  Masquer  Télécharger

http://www.hal.inserm.fr/inserm-00986268
Contributeur : Ed. Bmc <>
Soumis le : vendredi 2 mai 2014 - 01:30:00
Dernière modification le : mercredi 27 janvier 2016 - 17:35:41
Document(s) archivé(s) le : samedi 2 août 2014 - 11:10:39

Fichiers

1750-1172-9-67.pdf
Fichiers éditeurs autorisés sur une archive ouverte

Identifiants

Collections

Citation

Vincent Audard, Stéphane Moutereau, Gaetana Vandemelebrouck, Anoosha Habibi, Mehdi Khellaf, et al.. First evidence of subclinical renal tubular injury during sickle-cell crisis.. Orphanet Journal of Rare Diseases, BioMed Central, 2014, 9 (1), pp.67. 〈10.1186/1750-1172-9-67〉. 〈inserm-00986268〉

Partager

Métriques

Consultations de la notice

1093

Téléchargements de fichiers

161