Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
PLoS One. 2019 Nov 19;14(11):e0225310. doi: 10.1371/journal.pone.0225310. eCollection 2019.
Sickle cell disease (SCD) is associated with progressive multi-organ failure especially, the brain and kidney and leads to high morbidity and mortality rate. The aim of this study was to determine the prevalence of renal abnormalities among children with SCD. This cross-sectional study recruited 212 sickling positive patients comprising of 96 Hb AS, 48 Hb SC, and 68 Hb SS phenotypes from the Pediatric Unit of Wassa Akropong Government Hospital, Wassa Akropong, Ghana. Early morning urine and venous blood samples were collected from each participant. Urinalysis was conducted and serum urea and creatinine levels were estimated. Estimate glomerular filtration rate (eGFR) was calculated using the Swartz equation. Classification of chronic kidney disease (CKD) was based on 'The Kidney Disease: Improving Global Outcomes (KIDIGO)' criteria. The mean age of the children were 7.90 years. Serum creatinine (p = 0.0310) and urea (p<0.0001) levels were significantly higher among Hb AS participants compared with Hb SS phenotype. The prevalent indicators of renal abnormalities were proteinuria (26.4%), urine granular cast (5.6%) and CKD (39.6%). Proteinuria, urine granular cast and CKD were most prevalent among Hb SS (47.1%, 11.8% and 73.5% respectively) compared with Hb SC (41.7%, 8.3%, and 45.8% respectively) and Hb AS (4.2%, 0.0%, and 14.5%) phenotypes, respectively. Sickle cell conditions were significantly associated with proteinuria (p<0.0001) and CKD (p = 0.0378). Children with Hb SS [aOR = 5.04, 95% CI (2.47-10.3); p<0.0001] and Hb SC [aOR = 3.14 95% CI (1.39-7.01); p = 0.0174] were at increased odds of developing CKD after adjusting for age, BMI and gender. Proteinuria and CKD are associated with sickle cell disease (Hb SC and Hb SS). Renal function should be routinely monitored for children with SCD.
镰状细胞病（SCD）与多器官进行性衰竭有关，特别是大脑和肾脏，并导致高发病率和死亡率。本研究的目的是确定镰状细胞病患儿肾脏异常的发生率。这项横断面研究招募了来自加纳瓦萨阿克蓬政府医院儿科病房的 212 名镰状细胞阳性患者，包括 96 名 Hb AS、48 名 Hb SC 和 68 名 Hb SS 表型。从每位参与者采集清晨尿液和静脉血样本。进行尿液分析并估计血清尿素和肌酐水平。使用 Swartz 方程估算肾小球滤过率（eGFR）。慢性肾脏病（CKD）的分类基于“肾脏病：改善全球结局（KIDIGO）”标准。儿童的平均年龄为 7.90 岁。与 Hb SS 表型相比，Hb AS 参与者的血清肌酐（p = 0.0310）和尿素（p<0.0001）水平显著更高。肾脏异常的常见指标为蛋白尿（26.4%）、尿颗粒管型（5.6%）和 CKD（39.6%）。与 Hb SC（41.7%、8.3%和 45.8%）和 Hb AS（4.2%、0.0%和 14.5%）表型相比，Hb SS 中蛋白尿（47.1%）、尿颗粒管型（11.8%）和 CKD（73.5%）最为常见。镰状细胞病与蛋白尿（p<0.0001）和 CKD（p = 0.0378）显著相关。在调整年龄、BMI 和性别后，Hb SS [aOR = 5.04，95%CI（2.47-10.3）；p<0.0001]和 Hb SC [aOR = 3.14，95%CI（1.39-7.01）；p = 0.0174]发生 CKD 的几率增加。蛋白尿和 CKD 与镰状细胞病（Hb SC 和 Hb SS）相关。镰状细胞病患儿应常规监测肾功能。
