Renal abnormalities among children with sickle cell anaemia
Introduction: Sickle cell anaemia (SCA) is a noncommunicable disease of public health significance. SCA is characterized by chronic red blood cell haemolysis and vasoocclusion 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.
Key words: SCA, Renal abnormalities, haematuria, proteinuria, renal size, estimated glomerular filtration rate