Prevalence and correlates of microalbuminuria in Yemeni children with sickle cell disease.

Microalbuminuria (MA) has been recognized as a sensitive marker of early glomerular injury and a predictor of kidney dysfunction in patients with sickle cell disease (SCD). Limited data are available about MA in SCD children in the Arab countries and none from Yemen. The aim of this study is to determine the prevalence and correlates of MA among 101 children aged 1-16 years, with SCD at their steady state. Children were recruited during their routine health-care visits to the pediatric outpatient clinic in Al-Sadaqa general teaching hospital, Aden, Yemen, between September 2014 and February 2015. A random spot urine sample for each child was screened for MA using Micral-Test strips method. Data on clinical history, anthropometry, blood pressure (BP), and laboratory investigations were obtained. The overall prevalence of MA in this sample was 30.7%, with male predominance (80.6%) (P <0.05). The mean age of children with MA was 7.5 ± 3.2 years, and 10% of them were under five years of age. MA was correlated to both hemoglobin and hematocrit levels, which found to have protective effect against MA (Odds ratio = 0.17 and 0.59, respectively, P <0.05). No correlations were found between MA with age, height, weight, body mass index, recurrent clinical events (painful crises, blood transfusions, and hospitalizations), or fetal hemoglobin levels. BP measurements for all individuals were within the normal ranges, but systolic and diastolic BP were significantly higher in those with MA than without. This study demonstrated a high prevalence of MA in Yemeni children with SCD, and affecting young children as early as 2.5 years of age. Screening for MA as one of the early renal injury markers in children with SCD may help in the prevention of permanent loss of renal function and subsequent renal insufficiency in adulthood.