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首页> 外文期刊>European Journal of Haematology >Urinary albumin excretion is associated with pulmonary hypertension in sickle cell disease: potential role of soluble fms-like tyrosine kinase-1.
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Urinary albumin excretion is associated with pulmonary hypertension in sickle cell disease: potential role of soluble fms-like tyrosine kinase-1.

机译：尿白蛋白排泄与镰状细胞病中的肺动脉高压相关：可溶性fms-样酪氨酸激酶-1的潜在作用。

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摘要

BACKGROUND: Pulmonary hypertension (PHT) is reported to be associated with measures of renal function in patients with sickle cell disease (SCD). The purpose of this exploratory study was to determine the relationship between albuminuria and both clinical and laboratory variables in SCD. DESIGN AND METHODS: This cross-sectional study was performed using a cohort of adult patients with SCD and control subjects without SCD. Spot urine for microalbumin/creatinine ratio, measures of hemolysis, inflammation and other laboratory studies were obtained. Pulmonary artery systolic pressure was determined by Doppler echocardiography, and the diagnosis of PHT was defined using age-, sex- and body mass index-adjusted reference ranges. RESULTS: Seventy-three patients with SCD and 21 healthy, race-matched control subjects were evaluated. In patients with SCD, normoalbuminuria was observed in 34 patients (46.6%), microalbuminuria in 24 patients (32.9%) and macroalbuminuria in 15 patients (20.5%). There was a significant correlation between urine albumin excretion and age. In patients with HbSS and Sbeta(0) thalassemia, the levels of sFLT-1, soluble VCAM and NT pro-BNP were significantly higher in those with macroalbuminuria, compared to patients with microalbuminuria and normoalbuminura, but no significant differences were observed in the levels of laboratory measures of hemolysis. Urine albumin excretion was associated with PHT and a history of stroke. CONCLUSIONS: Our study confirms the high prevalence of albuminuria in SCD. The association of urine albumin excretion with sFLT-1 suggests that this vascular endothelial growth factor receptor family member may contribute to the development of albuminuria in SCD. By inducing endothelial activation and endothelial dysfunction, sFLT-1 appears to be a link between glomerulopathy and PHT in SCD.
机译：背景：据报道，肺动脉高压（PHT）与镰状细胞病（SCD）患者的肾功能指标有关。这项探索性研究的目的是确定蛋白尿与SCD中临床和实验室变量之间的关系。设计与方法：本研究采用队列研究，研究对象为成年SCD患者和无SCD的对照组。获得了尿液中微量白蛋白/肌酐比值，溶血，炎症和其他实验室研究的指标。通过多普勒超声心动图确定肺动脉收缩压，并使用年龄，性别和体重指数调整的参考范围定义PHT的诊断。结果：对73名SCD患者和21名健康，种族匹配的对照受试者进行了评估。在SCD患者中，观察到34例（46.6％）的白蛋白尿，24例（32.9％）的微白蛋白尿和15例（20.5％）的大白蛋白尿。尿白蛋白排泄与年龄之间存在显着相关性。 HbSS和Sbeta（0）地中海贫血患者的sFLT-1，可溶性VCAM和NT pro-BNP的水平明显高于具有微量白蛋白尿和正常白蛋白尿的患者，但水平无明显差异溶血的实验室措施。尿白蛋白排泄与PHT和中风病史有关。结论：我们的研究证实了在SCD中高蛋白尿的患病率。尿白蛋白排泄与sFLT-1的关联表明，该血管内皮生长因子受体家族成员可能有助于SCD中白蛋白尿的发展。通过诱导内皮激活和内皮功能障碍，sFLT-1似乎是肾小球病变和SCD中PHT之间的联系。

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