Albuminuria is the gold standard for the screening of microalbuminuria, a biomarker of early onset of nephropathy during sickle cell anemia (SCA). Nephropathy increase morbidity and mortality of SCA in the absence of appropriate treatment. However, albuminuria is not readily available or affordable in resource-limited countries, so in 2012 Kidney Diseases Improving Global Outcomes (KDIGO) proposed using proteinuria at a threshold of 150 mg/g urine creatinine to screen for microalbuminuria in these settings. The aim of this study was therefore to assess the performance of proteinuria in screening microalbuminuria in sub-Saharan Senegalese sickle cell patients. Albuminuria in recruited SS sickle cell patients was expressed as a urine albumin-to-creatinine ratio (UACR) and proteinuria as a urine proteins-to-creatinine ratio (UPCR). The prevalence of microalbuminuria, Cohen's kappa coefficient and areas under the curve (AUC) were then determined to assess the performance of proteinuria in detecting microalbuminuria. A total of 150 patients with a median age of 20 years [minimum-maximum: 4-57] and a female proportion of 51.33% were included in the study. Microalbuminuria was present in 42.38% (n=64) of subjects according to the UPCR. The Cohen's kappa coefficient was 0.41 [IC95%: 0.27-0.56] and the AUC 0.71 [IC95%: 0.64 - 0.81] with UPCR 150mg/g. The best Cohen's kappa coefficient and AUC were observed with an UPCR threshold of 135 mg/g. Our results confirm that proteinuria is useful in screening for microalbuminuria and show that RPCU 135 mg/g would be the optimal cut-off for detecting microalbuminuria in Senegalese sickle cell anemia patients.
| Published in | Advances in Biochemistry (Volume 12, Issue 2) |
| DOI | 10.11648/j.ab.20241202.14 |
| Page(s) | 76-84 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Sickle Cell Anemia, Kidney Disease, Albuminuria, Proteinuria
| [1] | R. E. Ware, M. de Montalembert, L. Tshilolo, M. R. Abboud, Sickle Cell Disease, Lancet. 390 (2017) 311–323. |
| [2] | P. Sundd, M. T. Gladwin, E. M. Novelli, Pathophysiology of Sickle Cell Disease, Annu. Rev. Pathol. 14 (2019) 263-292. |
| [3] | P. B. Piel, A. P. Patil, R. E. Howes, et al., Global epidemiology of sickle haemoglobin in neonates: a contemporary geostatistical model-based map and population estimates, Lancet. 381 (2013) 142‑151. |
| [4] | K. R. López, M. P. R. Andrés, Kidney abnormalities in sickle cell disease, Nefrologia. 31 (2011) 591–601. |
| [5] | A. M. Becker, Sickle cell nephropathy: challenging the conventional wisdom, Pediatr. Nephrol. 26 (2011) 2099‑2109. |
| [6] | K. A. Nath, R. P. Hebbel, Sickle cell disease: renal manifestations and mechanisms, Nat. Rev. Nephrol. 11 (2015) 161‑171. |
| [7] | D. R. Powars, D. D. Elliott-Mills, L. Chan, et al., Chronic Renal Failure in Sickle Cell Disease: Risk Factors, Clinical Course, and Mortality, Ann. Intern. Med. 115 (1991) 614‑620. |
| [8] | V. K. Derebail, Q. Zhou, E. J. Ciccone et al., Rapid decline in estimated glomerular filtration rate is common in adults with sickle cell disease and associated with increased mortality, Br. J. Haematol. 186 (2019) 900-907. |
| [9] | M. Seck, O. Ba, B. F. Faye, et al., Homozygous sickle cell disease related mortality in Senegal (2011-2020), EJHaem. 2 (2021) 711-715. |
| [10] | D. R. Powars, L. S. Chan, A. Hiti et al., Outcome of sickle cell anemia: a 4-decade observational study of 1056 patients, Medicine. 84 (2005) 363‑376. |
| [11] | V. Audard, P. Bartolucci et T. Stehlé, Sickle cell disease and albuminuria: recent advances in our understanding of sickle cell nephropathy, Clin. Kidney J. 10 (2017) 475‑478. |
| [12] | Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group, KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl. 3 (2013) 1-150, p31. |
| [13] | E. O. Gosmanova, S. Zaidi, J. Y. Wan, et al. Prevalence and progression of chronic kidney disease in adult patients with sickle cell disease, J Investig Med. 62 (2014) 804-807. |
| [14] | E. J. Lamb, G. R. D. Jones, Kidney function tests, In: N. Rifai, A. R. Horvath, C. T. Wittwer (Eds), Tietz fundamentals of clinical chemistry and molecular diagnostics, Elsevier Inc., St Louis, 2018, 359–376. |
| [15] | A. Bökenkamp, Proteinuria-take a closer look!, Pediatr. Nephrol. 35 (2020) 533-541. |
| [16] | R. J. Hogg, R. J. Portman, D. Milliner, et al., Evaluation and management of proteinuria and nephrotic syndrome in children: recommendations from a pediatric nephrology panel established at the National Kidney Foundation conference on proteinuria, albuminuria, risk, assessment, detection, and elimination (PARADE), Pediatrics. 105 (2000) 1242-1249. |
| [17] | B. Viteri, J. Reid-Adam, Hematuria and Proteinuria in Children, Pediatr. Rev. 39 (2018) 573-587. |
| [18] | K. Linnet, P. M. Bossuyt, K. G. Moons, et al., Quantifying the accuracy of a diagnostic test or marker, Clin Chem. 58 (2012) 1292-301. |
| [19] | X. Liu, Classification accuracy and cut-point selection, Stat Med. 31 (2012) 2676–2686. |
| [20] | T. J. Zhou, S. Raza, K. P. Nelson, et al. Methods of assessing categorical agreement between correlated screening tests in clinical studies, J Appl Stat. 48 (2021) 1861–1881. |
| [21] | K. G. Moons, J. A. de Groot, K. Linnet, et al., Quantifying the added value of a diagnostic test or marker, Clin Chem. 58 (2012) 1408-1417. |
| [22] | M. Li, Q. Gao, T. Yu, et al. Kappa statistic considerations in evaluating inter-rater reliability between two raters: which, when and context matters, BMC Cancer. 23 (2023) 799. |
| [23] | J. Cohen, A Coefficient of Agreement for Nominal Scales, Educ. Psychol. 20 (1960) 27-46. |
| [24] | M. Greiner, D. Pfeiffer, R. D. Smith, et al., Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests, Prev Vet Med. 45 (2000) 23–41. |
| [25] | J. R. Landis, G. G. Koch, The Measurement of Observer Agreement for Categorical Data, Biometrics, 33 (1977) 159. |
| [26] | A. S. Rigby, Statistical methods in epidemiology. v. Towards an understanding of the kappa coefficient, Disabil Rehabil. 22 (2000) 339–344. |
| [27] | E. H. M. Ndour, K. Mnika, F. Guèye-Tall, et al., Biomarkers of sickle cell nephropathy in Senegal, PLoS One. 17 (2022) e0273745. |
| [28] | O. Marsenic, K. G. Couloures, J. M. Wiley, et al., Proteinuria in children with sickle cell disease, Nephrol Dial Transplant. 23 (2007) 715–720. |
APA Style
Ndour, E. H. M., Dione, R., Gueye-Tall, F., Mara, S., Deme-Ly, I., et al. (2024). Performances of Proteinuria as Compared with Albuminuria in Screening for Microalbuminuria During Sickle Cell Anaemia. Advances in Biochemistry, 12(2), 76-84. https://doi.org/10.11648/j.ab.20241202.14
ACS Style
Ndour, E. H. M.; Dione, R.; Gueye-Tall, F.; Mara, S.; Deme-Ly, I., et al. Performances of Proteinuria as Compared with Albuminuria in Screening for Microalbuminuria During Sickle Cell Anaemia. Adv. Biochem. 2024, 12(2), 76-84. doi: 10.11648/j.ab.20241202.14
AMA Style
Ndour EHM, Dione R, Gueye-Tall F, Mara S, Deme-Ly I, et al. Performances of Proteinuria as Compared with Albuminuria in Screening for Microalbuminuria During Sickle Cell Anaemia. Adv Biochem. 2024;12(2):76-84. doi: 10.11648/j.ab.20241202.14
@article{10.11648/j.ab.20241202.14,
author = {El Hadji Malick Ndour and Rokhaya Dione and Fatou Gueye-Tall and Sokhna Mara and Indou Deme-Ly and Moussa Seck and Aliou Alioune Ndongo and Moustapha Djite and Helene Ange Therese Sagna-Bassene and Nene Oumou Kesso Barry and Pape Matar Kandji and Coumba Kamby and El Hadji Ousmane Sene and Papa Madieye Gueye and Ibrahima Diagne and Saliou Diop and Philomene Lopez-Sall and Aynina Cisse},
title = {Performances of Proteinuria as Compared with Albuminuria in Screening for Microalbuminuria During Sickle Cell Anaemia
},
journal = {Advances in Biochemistry},
volume = {12},
number = {2},
pages = {76-84},
doi = {10.11648/j.ab.20241202.14},
url = {https://doi.org/10.11648/j.ab.20241202.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ab.20241202.14},
abstract = {Albuminuria is the gold standard for the screening of microalbuminuria, a biomarker of early onset of nephropathy during sickle cell anemia (SCA). Nephropathy increase morbidity and mortality of SCA in the absence of appropriate treatment. However, albuminuria is not readily available or affordable in resource-limited countries, so in 2012 Kidney Diseases Improving Global Outcomes (KDIGO) proposed using proteinuria at a threshold of 150 mg/g urine creatinine to screen for microalbuminuria in these settings. The aim of this study was therefore to assess the performance of proteinuria in screening microalbuminuria in sub-Saharan Senegalese sickle cell patients. Albuminuria in recruited SS sickle cell patients was expressed as a urine albumin-to-creatinine ratio (UACR) and proteinuria as a urine proteins-to-creatinine ratio (UPCR). The prevalence of microalbuminuria, Cohen's kappa coefficient and areas under the curve (AUC) were then determined to assess the performance of proteinuria in detecting microalbuminuria. A total of 150 patients with a median age of 20 years [minimum-maximum: 4-57] and a female proportion of 51.33% were included in the study. Microalbuminuria was present in 42.38% (n=64) of subjects according to the UPCR. The Cohen's kappa coefficient was 0.41 [IC95%: 0.27-0.56] and the AUC 0.71 [IC95%: 0.64 - 0.81] with UPCR 150mg/g. The best Cohen's kappa coefficient and AUC were observed with an UPCR threshold of 135 mg/g. Our results confirm that proteinuria is useful in screening for microalbuminuria and show that RPCU 135 mg/g would be the optimal cut-off for detecting microalbuminuria in Senegalese sickle cell anemia patients.
},
year = {2024}
}
TY - JOUR T1 - Performances of Proteinuria as Compared with Albuminuria in Screening for Microalbuminuria During Sickle Cell Anaemia AU - El Hadji Malick Ndour AU - Rokhaya Dione AU - Fatou Gueye-Tall AU - Sokhna Mara AU - Indou Deme-Ly AU - Moussa Seck AU - Aliou Alioune Ndongo AU - Moustapha Djite AU - Helene Ange Therese Sagna-Bassene AU - Nene Oumou Kesso Barry AU - Pape Matar Kandji AU - Coumba Kamby AU - El Hadji Ousmane Sene AU - Papa Madieye Gueye AU - Ibrahima Diagne AU - Saliou Diop AU - Philomene Lopez-Sall AU - Aynina Cisse Y1 - 2024/06/13 PY - 2024 N1 - https://doi.org/10.11648/j.ab.20241202.14 DO - 10.11648/j.ab.20241202.14 T2 - Advances in Biochemistry JF - Advances in Biochemistry JO - Advances in Biochemistry SP - 76 EP - 84 PB - Science Publishing Group SN - 2329-0862 UR - https://doi.org/10.11648/j.ab.20241202.14 AB - Albuminuria is the gold standard for the screening of microalbuminuria, a biomarker of early onset of nephropathy during sickle cell anemia (SCA). Nephropathy increase morbidity and mortality of SCA in the absence of appropriate treatment. However, albuminuria is not readily available or affordable in resource-limited countries, so in 2012 Kidney Diseases Improving Global Outcomes (KDIGO) proposed using proteinuria at a threshold of 150 mg/g urine creatinine to screen for microalbuminuria in these settings. The aim of this study was therefore to assess the performance of proteinuria in screening microalbuminuria in sub-Saharan Senegalese sickle cell patients. Albuminuria in recruited SS sickle cell patients was expressed as a urine albumin-to-creatinine ratio (UACR) and proteinuria as a urine proteins-to-creatinine ratio (UPCR). The prevalence of microalbuminuria, Cohen's kappa coefficient and areas under the curve (AUC) were then determined to assess the performance of proteinuria in detecting microalbuminuria. A total of 150 patients with a median age of 20 years [minimum-maximum: 4-57] and a female proportion of 51.33% were included in the study. Microalbuminuria was present in 42.38% (n=64) of subjects according to the UPCR. The Cohen's kappa coefficient was 0.41 [IC95%: 0.27-0.56] and the AUC 0.71 [IC95%: 0.64 - 0.81] with UPCR 150mg/g. The best Cohen's kappa coefficient and AUC were observed with an UPCR threshold of 135 mg/g. Our results confirm that proteinuria is useful in screening for microalbuminuria and show that RPCU 135 mg/g would be the optimal cut-off for detecting microalbuminuria in Senegalese sickle cell anemia patients. VL - 12 IS - 2 ER -