Renal Parameters and Their Associations with Clinical Severity Score among Adult Sudanese with Sickle Cell Anemia

Abstract

Abstract: Background: As there is a global increase in survival of people living with Sickle Cell Anaemia (SCA); the prevalence of chronic complications including nephropathy is increased, so early identification, detection and management of these complications is mandatory. Objectives: This study aimed to investigate the estimated Glomerular Filtration Rate (eGFR), proteinuria and serum uric acid as markers of renal involvement in Sudanese adults with Sickle Cell Anaemia (SCA) and the relationship between these parameters and clinical severity score of SCA. Methods: This was hospital based, cross-sectional study. 55 participants Sudanese (32 Sickle cell anaemia group and 23 normal Hb A control group) were included in this study. Informed consent was obtained, Medical history was obtained and clinical examination was performed, blood and urine samples were taken from each participant. Severity score was calculated for sickle cell anaemia patients and Glomerular Filtration Rate (eGFR) was estimated, Uric acid level and urine for protein/creatinine ratio, were measured for each participant. Results: Hyper-filtration was manifested in 75% of Sickle cell anaemia group. Proteinuria (Protein/Creatinine Ratio) was significantly higher (P value > 0.001) in sickle cell anaemia group and significant proteinuria was detected in 12.5% among sickle cell anaemia group. Hyperuricemia only found in 6.3% of sickle cell group. The mean arterial blood pressure (MAP) was significantly lower (P

value 0.03) in sickle cell group. There was no association between the severity score and renal manifestations in the sickle cell anaemia group. Conclusions: Hyper-filtration and proteinuria were the most prevalent renal manifestations in the Sickle group. Higher levels of uric acid and lower blood pressure were observed in sickle patients when compared to controls. Recommendations: We recommend further studies to determine predictors of the renal disease and early detection and appropriate management of proteinuria, hyperuricemia in patients with sickle cell anaemia. We suggest development of modified severity score that include renal complications. Keywords: sickle cell anaemia, renal manifestations, glomerular filtration rate (GFR), uric acid.