Spectrum of renal abnormalities in children with sickle cell anaemia

Abstract

Background: In Nigeria, the spectrum of renal abnormalities in children with sickle cell anaemia has not been extensively studied. 

Objective: To determine the prevalence of various renal abnormalities (haematuria, hemoglobinuria, hyposthenuria, albuminuria glomerular filtration abnormalities and chronic kidney diseases) and their association with anaemia in children with sickle cell anaemia

Methods: A cross-sectional study of 146 children with sickle cell anaemia in steady state, aged 1- < 19 years, attending the Paediatric Haematology Outpatient Clinic at the University of Benin Teaching Hospital, Benin City, Nigeria. The method involved using interviewer-administered proforma, physical examination and determination of various renal parameters using urinalysis, urine microscopy, osmometer, urinometer, urine albumin creatinine ratio, and serum creatinine.

Results: The prevalence of the various renal abnormalities were, haematuria 10(6.8%), hemoglobinuria 9(6.2%), hyposthenuria 121(82.9%), microalbuminuria 51(34.9%), macroalbuminuria 6(4.1%), glomerular hyperfiltration 27(18.5%), glomerular hypofiltration 45(30.8%) and chronic kidney diseases 11(7.5%) The factors independently associated with anaemia were haemoglobinuria [odd ratio =8.3, 95% confidence interval of 1.970 -35.25(p = 0.009)], hyposthenuria [odd ratio= 0.1, 95% confidence interval of 0.047 -0.430 (p = 0.001)], haematuria [odd ratio 9.1 (95% confidence interval of 1.193 – 70.04 (p=0.06)] and albuminuria [odd ratio 2.9 (95% confidence interval of 1.006 – 8.611 p=0.06)].

Conclusion: In children with sickle cell anaemia, hyposthenuria is the most prevalent renal abnormality, followed by albuminuria and glomerular filtration abnormalities.