Prevalence and Clinical Factors Associated with Microalbuminuria in Children Aged 2-18years with Sickle Cell Anaemia at the National Referral Hospital in Kenya

Abstract

Background: Sub-Saharan Africa has a high burden of sickle cell disease. Morbidity caused by this disease includes damage to the kidneys which can be detected early by screening for increased renal excretion of albumin.
Objectives: To determine prevalence and clinical factors associated with microalbuminuria in children aged 2- 18years with sickle cell anaemia at Kenyatta National Hospital (KNH)
Design: Cross – sectional study
Methodology: Haemato-oncology clinic and Paediatric wards, Kenyatta National Hospital Stable children with sickle cell anaemia who met the inclusion criteria
Results: One hundred and ten children met the inclusion criteria with a mean age of 7.53yrs (+ 3.7). sixty two (56%) were male and 58(44%) female. We found the prevalence of microalbuminuria (MA) to be 39.1% with our youngest child being 2 years old. There was significant association with hyperfiltration (59 subjects; p=0.006, OR 3.06 95% CI 1.36 to 6.92) but no significant association with age (p=0.805), gender (p=0.926), BMI ( p=0.538), number of hospitalisations (p=0.679) or haemoglobin concentration (p=0.58).
Conclusion: The prevalence of MA in our population is high and warrants regular screening of all SCD patients. The onset was also noted to be at an early age thus this screening should start as soon as the diagnosis is made.