Renal Status of Children With Sickle Cell Disease in Accra, Ghana

Abstract

Introduction: In West Africa, the prevalence of sickle cell disease (SCD) is 2%. The disease adversely affects growth, development and organ function including the kidneys. There is however a dearth of information about the renal status of SCD children in Ghana. Objectives: To assess the renal status of children with SCD in steady state. Design: A cross-sectional case-control study. Setting: Paediatric Sickle Cell Clinic, Korle Bu Teach-ing Hospital, Accra. Participants: Cases-357 SCD cases and 70 of their HbAA siblings as controls. Methods: Documentation of their socio-demographic data, clinical data and dipstick urinalysis findings, and renal ultrasonography on selected participants. Results: The mean [SD] age was 7.18 [3.15]yrs for cases and 5.16[3.28]yrs for controls. The genotypes were Hb SS (76.7%), Hb SC (21.8 %), and Hb Sβthal (1.4%). Urinalysis showed leucocyturia in 12.6% ver-sus 5.7% (χ2=62.5 and the p=0.000)), isolated proteinu-ria in 2.8% versus 1.43% (χ2=10.01 and p=0.001) haematuria in 2.6% versus 0% (χ2=9.233, p=0.002) and nitrites in 2.2% versus 1.4% (χ2 =16.3,p=0.02) of cases and controls respectively. The youngest SCD case with proteinuria was 2yrs. old. Proteinuria prevalence in-creased with age, , occurring in 5.7% of cases aged 9-11yrs. and 20.6% of cases aged 12yrs. Two-thirds of the proteinuria cases were aged 9-12yrs., of whom 50% were aged 12yrs. Renal ultrasound findings were normal in all those examined. Conclusion: Urinary abnormalities suggesting neph-ropathy occur early in SCD patients in Ghana. Routine dipstick screening at clinic visits countrywide would help early detection and prompt intervention to limit renal impairment.