Renal Abnormalities among Egyptian Children with Hemophilia A Using Renal Scintigraphy: Relation to Risk Factors and Disease Severity
Hamed A.; shalaby, mennatallah; El-Kinawy N.; Elamawy A.; Abd El-Ghany S.;
Abstract
© 2017 SAGE Publications. Many risk factors may contribute to renal disease in patients with hemophilia A. Aim: We aimed to evaluate functional and structural renal abnormalities among a group of Egyptian children with severe and moderate hemophilia A using technetium-99m diethylene triamine pentaacetic acid ( 99m Tc-DTPA) and technetium-99 m dimercaptusuccinic acid ( 99m Tc-DMSA) scan. We also aimed to determine the relation between these abnormalities and different risk factors and disease severity. Patients and methods: Forty male patients, 16 with severe and 24 with moderate hemophilia A, were enrolled in this study. Their mean age was 10.2 ± 4.3 years (range, 5-17 years). Full history taking, clinical examination, laboratory, and radionuclide investigations including serum creatinine, blood urea nitrogen (BUN), urine analysis, creatinine clearance, 24-hour urinary protein, 99m Tc-DTPA scan, and 99m Tc-DMSA scan were performed to all enrolled patients. Results: Serum creatinine and BUN were normal in all patients, and corrected creatinine clearance was diminished in 2 patients. However, 99m Tc-DTPA results yielded 19 (47.5%) patients with diminished glomerular filtration rate (GFR). Moreover, it showed that 14 (35%) had obstructive uropathy, 15 (37.5%) had obstructive nephropathy, while 11 (27.5%) patients showed normal scan. One patient had atrophy of 1 kidney on 99m Tc-DMSA scan. Among our cohort, 5 (12.5%) patients were hypertensive. Microscopic hematuria was detected in 14 (35%) patients while 72.5% had proteinuria. We found an association between hematuria and hypertension with diminished GFR. Conclusion: Despite normal kidney functions (serum creatinine and BUN), we found a high rate of diminished GFR and obstructive uropathy and nephropathy as detected by 99m Tc-DTPA scan among children with hemophilia A.
Other data
Title | Renal Abnormalities among Egyptian Children with Hemophilia A Using Renal Scintigraphy: Relation to Risk Factors and Disease Severity | Authors | Hamed A. ; shalaby, mennatallah ; El-Kinawy N. ; Elamawy A. ; Abd El-Ghany S. | Issue Date | 1-Jul-2017 | Journal | Clinical and Applied Thrombosis/Hemostasis | DOI | 5 478 http://api.elsevier.com/content/abstract/scopus_id/85020467805 23 1938-2723 10.1177/1076029615619484 |
PubMed ID | 26659696 | Scopus ID | 2-s2.0-85020467805 |
Attached Files
File | Description | Size | Format | |
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paper no 3.pdf | 1.09 MB | Adobe PDF | View/Open |
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