Biomarcadores de lesão na nefropatia falciforme

• Autor(a) principal: Mendonça, Ivone Camargo Damasceno
• Data de Publicação: 2012
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: https://ri.ufs.br/handle/riufs/3764
• topic: Albuminúria; Anemia falciforme; Lactato desidrogenase; Albuminuria; Lactate dehydrogenase; Sickle cell anemia; CNPQ::CIENCIAS DA SAUDE

Sickle cell anemia is a disorder of genetic hemoglobin more common around the world, characterized by the presence of abnormal hemoglobin S. The phenomena of vaso-occlusion and anemia characteristics cause tissue damage leading to organ damage, including the kidneys. The various types of renal abnormalities occur primarily in the renal medulla. Clinical manifestations of sickle cell nephropathy start early, often before one year of age with glomerular hyperfiltration, hyposthenuria, renal tubular acidosis distal and, over time, increase in albuminuria. The lactate dehydrogenase (LDH) is considered a useful marker of hemolysis and its levels are very high in the presence of intravascular hemolysis, as indicated by some authors as associated with various complications related to hemolysis, including renal complications. In order to identify laboratory variables associated with renal injury in patients with sickle cell anemia, a cross-sectional study was conducted in children, teenagers and young adults treated in the hematology ward of the HU-UFS, from October 2010 to June 2011. Laboratory tests were performed in 124 patients with sickle cell anemia, mean age 13.3 + 6.4 years (2 - 32 years), 56.5 % were male. There was a frequency of microalbuminuria and proteinuria 19.4 % and 18.5% respectively. The frequency of glomerular hyperfiltration was 63.7 %. Elevation of LDH occurred in 95 % of patients and correlated positively with microalbuminuria, with percentages of reticulocytes and inversely with average rates of hemoglobin. Although univariate analysis revealed a significant positive correlation between the levels of LDH and microalbuminuria, these values were not significantly different between patients with or without microalbuminuria, suggesting that the association with renal injury is not specific, since it was also associated with markers of hemolysis. It is concluded that, levels of LDH present variability independently of microalbuminuria, because LDH levels were not able to distinguish patients with and without microalbuminuria.