Detection of Occult Glomerular Dysfunction in Glucose Six Phosphate Dehydrogenase Deficiency Anemia

Abstract

Background: Glucose six phosphate dehydrogenase deficiency (G6PD) anemia is associated with intravascular hemolysis. The freely filtered hemoglobin can damage the kidney. We aimed to assess gloumerular status in G6PD children.Methods: Sixty children were included. Thirty G6PD deficiency anemia children were enrolled during the acute hemolytic crisis and after hemolytic episode. Another thirty healthy children were included as controls. Serum cystatin C, creatinine levels and urinary albumin/creatinine (A/C) ratio were measured for glomerular filtration rate (GFR) calculation.Results:Significantly higher urinary A/C ratio and lower GFR were found during hemolysis and after the hemolytic episode compared to controls. Also, significant higher serum cystatin C, creatinine and A/C ratio and lower GFR during acute hemolytic crisis compared to the same children after the hemolytic episode subsided. Conclusions:G6PD deficiency anemia is associated with a variable degree of glomerular dysfunction during acute hemolytic episodes. This glomerular dysfunction can result in chronic subclinical or occult chronic kidney injury.