Factors associated with microalbuminuria among Children with sickle cell disease in a tertiary centre in South-South Nigeria

Abstract

Background: Microalbuminuria, an early indicator of kidney damage in Sickle Cell Disease (SCD) patients, is linked to
a heightened risk of chronic kidney disease (CKD) in adulthood. This study investigates the determinants of
microalbuminuria in paediatric SCD patients in South-South Nigeria.
Methodology: This cross-sectional study was conducted over six months at the Rivers State University Teaching
Hospital, Nigeria, involving 60 children with [HbSS genotype, SCD] in a steady state. Data collection included
demographics, past medical history, clinical measurements, and laboratory assessments of urine and blood samples.
‘Steady state’ was defined as SCD with a known 'steady state' haemoglobin level and stable clinical state for ≥ 3 months.
Microalbuminuria was defined spot urine albumin-creatinine ratio of 30mg/g to <300 mg/g.
Results: Of the 60 children recruited, 31 children (51.7%) were males. The mean age was 9.6 ± 4.3 years. The
prevalence of microalbuminuria was 16.7% (CI: 8.29 – 28.5%) and associated risk factors were hypertension (p =
0.017), use of Hydroxyurea (p = 0.008), and Ciklavit (p = 0.025), but not NSAIDs (p = 0.046). There was a significant
negative correlation (ɼ = -0.28; p = 0.032) between haemoglobin level and microalbuminuria.
Conclusion: This study provides insights into the factors associated with microalbuminuria in children with SCD in our
setting and highlights the need for early screening for markers of CKD among children with SCD. Further research is
needed to ascertain the potential benefits of addressing anaemia and reducing haemolysis in mitigating the occurrence of
microalbuminuria among children with SCD.