Renal abnormalities among children with sickle cell anaemia

Abstract

Abstract: Introduction: Sickle cell anaemia (SCA) is a non- communicable disease of public health significance. SCA is characterized by chronic red blood cell haemolysis and vaso- occlusion which further complicated by nitric oxide deficiency, causes oxidative damage to the body organs especially the kidneys.

Objectives: To document the prevalence of renal function and structural abnormalities in children with SCA in a teaching hospital in north western Nigeria.

Materials and Methods: One hundred and ten subjects with SCA in steady state without known renal or cardiac abnormalities were enrolled and matched for age and sex with controls (haemoglobin AA). Interviewer-administered questionnaires, clinical examination and renal ultrasound scans were carried out. Urinalysis, spot urine albumin creatinine ratio and serum creatinine were carried out using standardized laboratory methods.

Results: Eleven (10.3%) children with SCA had haematuria while 6.5% had overt proteinuria. Children with SCA who had proteinuria were five times more likely, to develop haematuria than the controls with proteinuria (p = 0.03). Microalbuminuria was found in 24.3% of children with SCA. The mean estimated glomerular filtration rate was normal for both subjects and controls. Only three (2.8%) of the SCA subjects had increased renal echogenicity all of whom had microalbuminuria and were older than nine years.

Conclusion and recommendations: Renal abnormalities were found in children with SCA occurring as early as 4 years of age. Regular screening for renal disease in children with SCA is recommended to ensure management modalities are instituted early.

Keywords: SCA, Renal abnormalities, haematuria, proteinuria, renal size, estimated glomerular filtration rate