{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:23:20Z","timestamp":1791411800142,"version":"4.3.3"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T00:00:00Z","timestamp":1546905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["5K23HL127100"],"award-info":[{"award-number":["5K23HL127100"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In patients with diabetes mellitus, hyperfiltration precedes the development of albuminuria. Pediatric sickle cell anemia (SCA) patients have a high prevalence of hyperfiltration and albuminuria during early childhood and adolescence. We tested the hypothesis that hyperfiltration precedes the development of albuminuria in a longitudinal pediatric SCA cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We identified 91 participants with HbSS or SB0 thalassemia 5\u201021\u2009years of age enrolled in a longitudinal sickle cell nephropathy cohort study who had a cystatin C measured during early childhood (4\u201010 years of age). Early hyperfiltration was defined as a mean eGFR &gt;180\u2009mL\/min\/1.73m\n                      <jats:sup>2<\/jats:sup>\n                      using cystatin C obtained from 4 to 10 years of age. Persistent albuminuria was defined as an albumin to creatinine ratio\u2009&gt;\u200930\u2009mg\/g on two of three untimed urine specimens. Time to event analysis estimated survival curves for participants with and without hyperfiltration using Kaplan\u2010Meier curves and used logrank test for categorical variables to assess the association with time to development of the first episode persistent albuminuria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Persistent albuminuria occurred more often and at an earlier age in participants with early hyperfiltration compared to those without early hyperfiltration (log\u2010rank,\n                      <jats:italic>P<\/jats:italic>\n                      =\u2009.004). Participants who developed albuminuria have a significant increase in their eGFR during childhood (\n                      <jats:italic>P<\/jats:italic>\n                      =\u2009.003) as compared to participants who have not yet progressed to albuminuria (\n                      <jats:italic>P<\/jats:italic>\n                      =\u2009.26). For every 1 g\/dL increase in hemoglobin, the hazard ratio for developing persistent proteinuria decreased by 0.56 (95% CI: 0.3, 1.06,\n                      <jats:italic>P<\/jats:italic>\n                      =\u2009.07).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hyperfiltration precedes the development of persistent proteinuria in pediatric SCA patients. Intervention strategies should target lowering eGFR during early childhood.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ajh.25390","type":"journal-article","created":{"date-parts":[[2018,12,28]],"date-time":"2018-12-28T02:33:45Z","timestamp":1545964425000},"page":"417-423","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":81,"title":["Hyperfiltration during early childhood precedes albuminuria in pediatric sickle cell nephropathy"],"prefix":"10.1002","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5011-1022","authenticated-orcid":false,"given":"Jeffrey D.","family":"Lebensburger","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology Oncology University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inmaculada","family":"Aban","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandi","family":"Pernell","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology Oncology University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malgorzata","family":"Kasztan","sequence":"additional","affiliation":[{"name":"Division of Cardio\u2010Renal Physiology and Medicine University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel I.","family":"Feig","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee M.","family":"Hilliard","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology Oncology University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Askenazi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2005.00590.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1996.265"},{"key":"e_1_2_8_4_1","first-page":"S236","article-title":"The role of intraglomerular pressure in the initiation and progression of renal disease","volume":"4","author":"Anderson S","year":"1986","journal-title":"J Hypertens 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