POTENTIAL MEDICAL APPLICATIONS OF TRANSCRANIAL DOPPLER VELOCITIES IN CHILDREN WITH SICKLE CELL DISEASE

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Kendra Shuford (Creator)

Institution

East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Abstract: Although it is a topic of importance , research is scarce concerning renal dysfunction in pediatric sickle cell patients. Elevated blood pressure , increased urinary protein , and other signs and symptoms of early chronic kidney disease (CKD) are commonly found in children with sickle cell disease (SCD); the purpose of this study was to investigate a potential method for detecting renal dysfunction and the signs of CKD in children before the problem escalates. Transcranial Doppler (TCD) is a method used in sickle cell patients to determine their risk of stroke. It has to be presumed that in addition to CNS vasculopathy , SCD cause vasculopathy in other organs. It is not clear if there is a relationship between TCD velocity and renal damage. The purpose of this study was to investigate the relationship between TCD values and renal function. After obtaining appropriate institutional review board (IRB) approval , a retrospective chart review of 90 pediatric sickle cell patients managed at Vidant Medical Center , in Greenville in North Carolina was performed , to test the use of TCD in detecting dysfunction in the renal system. Statistical analysis was then completed to evaluate the relationship between these variables. The renal values collected were serum creatinine (SCR) and urine creatinine (UCR) , blood urea nitrogen BUN , and Albumin/Creatinine Ratio (ACR); these renal values were individually analyzed. The TCD values collected consisted of the maximum velocities of the right middle cerebral artery (rMCA) , left middle cerebral artery (lMCA) , right internal carotid artery (rICA) , and left internal carotid artery (l ICA). Based on their TCD values , patients were categorized as normal , conditionally abnormal , or abnormal. There was a statistically significant difference in the SCR values across the three subject groups , however , this finding may be questioned when age is factored into this variable. The results indicate that BUN , UCR , and ACR cannot be used to determine if TCD velocities are a useful tool in the early detection of renal dysfunction in patients with sickle cell disease. However , lower SCR values were seen in patients with higher TCD velocities , therefore the use of TCD values to detect renal dysfunction should not be ruled out based on this study.

Additional Information

Publication

Thesis

Language: English

Date: 2017

Keywords

Sickle Cell Disease, Transcranial Doppler, Renal Dysfunction

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