Prevalence of sickle cell trait in dialysis patients

Prevalência de traço falciforme em pacientes dialíticos

BRIEF COMMUNICATION

Prevalence of sickle cell trait in dialysis patients

Prevalência de traço falciforme em pacientes dialíticos

Luana Isaias^I; Suzane Bertoni^II; Ana Luiza Barbosa dos Santos^III; Esperança da Luz Tinoco Ribeiro^IV; Lívia Borsato^IV; Hye Chung Kang^V

^IAttending Master's in General Pathology at the Post-Graduation Program in Pathology - Universidade Federal Fluminense-Medical School (UFF)

^IIGraduate student in Biomedicine at UFF; scholarship student at Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)

^IIIMaster's in Human Pathology at the Post-Graduation Program in Pathology - UFF-Medical School

^IVNurse at the Dialysis Center of Antônio Pedro University Hospital-UFF

^VDoctor in Pharmacy (Clinical Analysis) by Universidade de São Paulo (USP); associate professor at UFF-Pathology Department

^{Mailing address}

ABSTRACT

The sickle cell nephropathy is described as a homozygous sickle cell disease. However, there is no consensus as to the heterozygotes, thus other investigations are required to provide further information on this topic. This study aimed at determining the frequency of sickle cell trait in a population of chronic renal failure patients in the city of Niterói.

Key words: sickle cell trait; kidney disease; hemodialysis.

RESUMO

A nefropatia falciforme é descrita entre os homozigotos da doença falcêmica, entretanto, para os heterozigotos, ainda não há um consenso, sendo necessários mais estudos que possam fornecer essas informações. Este estudo teve como objetivo determinar a frequência de traço falcêmico em uma população de doentes renais crônicos da cidade de Niterói.

Unitermos: traço falciforme; doença renal; hemodiálise.

INTRODUCTION

Anemia, a common complication in chronic renal disease⁽¹⁾, may be correlated with severe renal dysfunction^{(4, 5)}. It appears early in the disease course and features a multifactorial hematological profile, including erythropoietin deficiency^{(1, 4)}. However, genetic changes in hemoglobin also cause anemia, namely hemoglobinopathies. These are among the most common genetic mutations in the general population^{(2, 4)}. Nevertheless, they are not extensively studied as a cause of anemia in patients with kidney disease, despite the fact that there are studies that correlate the presence of sickle hemoglobin with kidney damage. Thus, we aimed at determining the frequency of S hemoglobinopathy in a population of chronic renal patients and verifying the correlation between renal damage and presence of hemoglobinopathy.

MATERIAL AND METHODS

We collected 5 ml of blood sample with ethylenediaminetetra acetic acid (EDTA) from patients with predialysis chronic kidney disease (stage 5). Sickling and solubility tests as well as hemoglobin electrophoresis on alkaline pH were performed. Comorbidities and laboratory data were collected from medical records.

RESULTS AND DISCUSSION

The sample comprised 110 individuals (65 males and 45 females), mean age 57 years (± 18.1), in which hypertension was the most prevalent comorbidity, present in 49% of the subjects. The observed predominance of hypertension was higher in comparison with other surveys published in Brazil, which included a population basis from the South and Southeast and reported prevalences of 22.3% and 43.9%, respectively⁽⁶⁾.

The sample revealed 3.6% of patients with sickle cell trait, including two males and two females. Mean age was 63.3 ± 11.5 years, and one patient had a history of hypertension and cerebral vascular accident. This prevalence of sickle cell trait was similar to that reported in the general adult population of the state of Rio de Janeiro (4% by Murão⁽³⁾ in 2007 and 3.9% by Naoum in 2012⁽⁴⁾).

Anemia was observed in 87.3% of patients, which raises the issue of how they were uncompensated and how this created impact on their quality of life, inasmuch as the higher the degree of anemia, the worse the renal function⁽¹⁾.

Therefore, we concluded that there was no difference between the prevalence of sickle cell trait in the sample of individuals with kidney disease and the general population. Furthermore, there was no correlation between renal damage and the presence of sickle cell trait.

ACKNOWLEDGEMENTS

To the professional staff from the Dialysis Center-Antonio Pedro University Hospital and the patients admitted there, subjects of this research.

ETHICAL CONSIDERATIONS

The project was registered at the Ethics and Research Committee of Antonio Pedro University Hospital-Medical School (Comitê de Ética e Pesquisa da Faculdade de Medicina do Hospital Universitário Antonio Pedro [CEP/HUAP]) under nº 050/08.

First submission on 01/01/13

last submission on 13/01/13

accepted for publication on 14/01/13

published on 20/08/13

• 1. ABENSUR, H. Deficiência de ferro na doença renal crônica. Rev Bras Hematol Hemoter, v. 32, n. 2, 2010. Disponível em: <http://www.scielo.br/revistas>. Acesso em: 1 jan. 2013.
• 2. HOLSBACH, D. R. et al Ocorrência de hemoglobina S no estado de Mato Grosso do Sul, Brasil. J Bras Patol Med Lab, v. 44, n. 4, 2008.
• 3. MURAO, M.; FERRAZ, M. H. C. Traço falciforme - heterozigose para hemoglobina S. Rev Bras Hematol Hemoter, v. 29, n. 3, 2007.
• 4. NAOUM, F. A. Doenças que alteram os exames hematológicos. São Paulo: Editora Atheneu, 2010.
• 5. SHAHEEN, F. A. et al Prevalence of anemia in predialysis chronic kidney disease patients. Saudi J Kidney Dis Transpl, v. 22, n. 3, p. 456-63, 2011.
• 6. SOUTELLO, A. L. et al. Psychometric performance of the Brazilian version of the mini-cuestionario de calidad de vida en la hipertensión arterial (MINICHAL). Rev Lat Am Enfermagem, v. 19, n. 4, p. 855-64, 2011.

Publication Dates

• Publication in this collection
  11 Dec 2013
• Date of issue
  Aug 2013

History

• Received
  01 Jan 2013
• Accepted
  20 Aug 2013
• Reviewed
  13 Jan 2013