Sickle Cell Nephropathy and Associated Factors among Asymptomatic Children with Sickle Cell Anaemia
Background. Sickle cell nephropathy (SCN) is a serious complication of sickle cell anaemia (SCA) with asymptomatic onset in childhood and possible progression to chronic kidney disease (CKD). In Southeast Nigeria, few studies have evaluated renal function in paediatric SCA patients for early detecti...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | International Journal of Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2020/1286432 |
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| author | Uchenna Modestus Nnaji Christian Chukwukere Ogoke Henrietta Uche Okafor Kingsley I. Achigbu |
| author_facet | Uchenna Modestus Nnaji Christian Chukwukere Ogoke Henrietta Uche Okafor Kingsley I. Achigbu |
| author_sort | Uchenna Modestus Nnaji |
| collection | DOAJ |
| description | Background. Sickle cell nephropathy (SCN) is a serious complication of sickle cell anaemia (SCA) with asymptomatic onset in childhood and possible progression to chronic kidney disease (CKD). In Southeast Nigeria, few studies have evaluated renal function in paediatric SCA patients for early detection of renal impairment and early intervention to reduce morbidity and mortality. Therefore, this study evaluated the renal function of paediatric SCA patients in a steady state based on glomerular filtration rate and urinalysis findings (proteinuria and haematuria). Methods. A cross-sectional study of consecutively recruited sixty haemoglobin SS (HbSS) children in a steady state and sixty age- and sex-matched haemoglobin AA (HbAA) controls aged 2–18 years was done. Renal function of HbSS subjects was evaluated using estimated glomerular filtration rate (eGFR) which was compared with healthy HbAA subjects. The prevalence of significant proteinuria and haematuria, its association with eGFR, and the effect of past sickle cell crisis (in the preceding 24 months) on renal function were also evaluated. Results. Mean eGFR was significantly higher in HbSS subjects than in the HbAA subjects (p=0.001) and decreased with age. Significant proteinuria and haematuria were more prevalent in the HbSS group (3.4% and 6.7%, respectively) compared to the HbAA subjects (0% and 0%, respectively) (p=0.496 and 0.119, respectively). No significant association was observed between eGFR and proteinuria (p=1.000) or haematuria (p=1.000). There was a positive correlation between eGFR and frequency of past painful crisis that required hospitalization (r=0.138, p=0.295) and between eGFR and frequency of blood transfusion (r=0.679, p≤0.001). Conclusions. Asymptomatic paediatric HbSS (SCA) patients had higher mean eGFR indicating an increased risk of nephropathy. There was no association between eGFR and proteinuria or haematuria. Frequent sickle cell crises especially one requiring transfusion were positively correlated with hyperfiltration. |
| format | Article |
| id | doaj-art-03b242d25ed443369938d9cfda0c47f8 |
| institution | Kabale University |
| issn | 1687-9740 1687-9759 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Pediatrics |
| spelling | doaj-art-03b242d25ed443369938d9cfda0c47f82025-02-03T01:28:43ZengWileyInternational Journal of Pediatrics1687-97401687-97592020-01-01202010.1155/2020/12864321286432Sickle Cell Nephropathy and Associated Factors among Asymptomatic Children with Sickle Cell AnaemiaUchenna Modestus Nnaji0Christian Chukwukere Ogoke1Henrietta Uche Okafor2Kingsley I. Achigbu3Department of Paediatrics, Federal Medical Centre, Owerri, NigeriaDepartment of Clinical Neurophysiology & Child Neurology, Mother Healthcare Diagnostics & Hospital, Owerri, NigeriaDepartment of Paediatrics, University of Nigeria, Enugu Campus & University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, NigeriaDepartment of Paediatrics, Federal Medical Centre, Owerri, NigeriaBackground. Sickle cell nephropathy (SCN) is a serious complication of sickle cell anaemia (SCA) with asymptomatic onset in childhood and possible progression to chronic kidney disease (CKD). In Southeast Nigeria, few studies have evaluated renal function in paediatric SCA patients for early detection of renal impairment and early intervention to reduce morbidity and mortality. Therefore, this study evaluated the renal function of paediatric SCA patients in a steady state based on glomerular filtration rate and urinalysis findings (proteinuria and haematuria). Methods. A cross-sectional study of consecutively recruited sixty haemoglobin SS (HbSS) children in a steady state and sixty age- and sex-matched haemoglobin AA (HbAA) controls aged 2–18 years was done. Renal function of HbSS subjects was evaluated using estimated glomerular filtration rate (eGFR) which was compared with healthy HbAA subjects. The prevalence of significant proteinuria and haematuria, its association with eGFR, and the effect of past sickle cell crisis (in the preceding 24 months) on renal function were also evaluated. Results. Mean eGFR was significantly higher in HbSS subjects than in the HbAA subjects (p=0.001) and decreased with age. Significant proteinuria and haematuria were more prevalent in the HbSS group (3.4% and 6.7%, respectively) compared to the HbAA subjects (0% and 0%, respectively) (p=0.496 and 0.119, respectively). No significant association was observed between eGFR and proteinuria (p=1.000) or haematuria (p=1.000). There was a positive correlation between eGFR and frequency of past painful crisis that required hospitalization (r=0.138, p=0.295) and between eGFR and frequency of blood transfusion (r=0.679, p≤0.001). Conclusions. Asymptomatic paediatric HbSS (SCA) patients had higher mean eGFR indicating an increased risk of nephropathy. There was no association between eGFR and proteinuria or haematuria. Frequent sickle cell crises especially one requiring transfusion were positively correlated with hyperfiltration.http://dx.doi.org/10.1155/2020/1286432 |
| spellingShingle | Uchenna Modestus Nnaji Christian Chukwukere Ogoke Henrietta Uche Okafor Kingsley I. Achigbu Sickle Cell Nephropathy and Associated Factors among Asymptomatic Children with Sickle Cell Anaemia International Journal of Pediatrics |
| title | Sickle Cell Nephropathy and Associated Factors among Asymptomatic Children with Sickle Cell Anaemia |
| title_full | Sickle Cell Nephropathy and Associated Factors among Asymptomatic Children with Sickle Cell Anaemia |
| title_fullStr | Sickle Cell Nephropathy and Associated Factors among Asymptomatic Children with Sickle Cell Anaemia |
| title_full_unstemmed | Sickle Cell Nephropathy and Associated Factors among Asymptomatic Children with Sickle Cell Anaemia |
| title_short | Sickle Cell Nephropathy and Associated Factors among Asymptomatic Children with Sickle Cell Anaemia |
| title_sort | sickle cell nephropathy and associated factors among asymptomatic children with sickle cell anaemia |
| url | http://dx.doi.org/10.1155/2020/1286432 |
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