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尼日利亚南南地区一家三级中心镰状细胞病患儿微量白蛋白尿的相关因素

Factors Associated with Microalbuminuria among Children with Sickle Cell Disease in a Tertiary Centre in South-South Nigeria.

作者信息

Briggs Datonye Christopher, Okechukwu Chioma, Apollus Josiah, Amadi Ijeoma, Omunakwe Hannah, Dublin-Green Linda Anucha, Okoh Dorathy

机构信息

Paediatric Nephrology division, Department of Paediatrics, Rivers State University Teaching Hospital & Faculty of Clinical Sciences, Rivers State University, Nigeria.

Paediatric Haemato-oncology unit, Department of Paediatrics, Rivers State University Teaching Hospital & Faculty of Clinical Sciences, Rivers State University, Nigeria.

出版信息

Niger Med J. 2025 Jan 10;65(6):885-898. doi: 10.60787/nmj-v65i6.493. eCollection 2024 Nov-Dec.

Abstract

BACKGROUND

Microalbuminuria, an early indicator of kidney damage in Sickle Cell Disease (SCD) patients, is linked to a heightened risk of chronic kidney disease (CKD) in adulthood. This study investigates the determinants of microalbuminuria in paediatric SCD patients in South-South Nigeria.

METHODOLOGY

This cross-sectional study was conducted over six months at the Rivers State University Teaching Hospital, Nigeria, involving 60 children with [HbSS genotype, SCD] in a steady state. Data collection included demographics, past medical history, clinical measurements, and laboratory assessments of urine and blood samples. 'Steady state' was defined as SCD with a known 'steady state' haemoglobin level and stable clinical state for ≥ 3 months. Microalbuminuria was defined spot urine albumin-creatinine ratio of 30mg/g to <300 mg/g.

RESULTS

Of the 60 children recruited, 31 children (51.7%) were males. The mean age was 9.6 ± 4.3 years. The prevalence of microalbuminuria was 16.7% (CI: 8.29 - 28.5%) and associated risk factors were hypertension (p = 0.017), use of Hydroxyurea (p = 0.008), and Ciklavit (p = 0.025), but not NSAIDs (p = 0.046). There was a significant negative correlation (ɼ = -0.28; p = 0.032) between haemoglobin level and microalbuminuria.

CONCLUSION

This study provides insights into the factors associated with microalbuminuria in children with SCD in our setting and highlights the need for early screening for markers of CKD among children with SCD. Further research is needed to ascertain the potential benefits of addressing anaemia and reducing haemolysis in mitigating the occurrence of microalbuminuria among children with SCD.

摘要

背景

微量白蛋白尿是镰状细胞病(SCD)患者肾脏损伤的早期指标,与成年后患慢性肾脏病(CKD)的风险增加有关。本研究调查了尼日利亚东南部儿科SCD患者微量白蛋白尿的决定因素。

方法

本横断面研究在尼日利亚河流州立大学教学医院进行了6个月,纳入了60例处于稳定状态的[HbSS基因型,SCD]儿童。数据收集包括人口统计学、既往病史、临床测量以及尿液和血液样本的实验室评估。“稳定状态”定义为具有已知“稳定状态”血红蛋白水平且临床状态稳定≥3个月的SCD。微量白蛋白尿定义为随机尿白蛋白肌酐比值为30mg/g至<300mg/g。

结果

在招募的60名儿童中,31名儿童(51.7%)为男性。平均年龄为9.6±4.3岁。微量白蛋白尿的患病率为16.7%(CI:8.29 - 28.5%),相关危险因素为高血压(p = 0.017)、使用羟基脲(p = 0.008)和Ciklavit(p = 0.025),但不包括非甾体抗炎药(p = 0.046)。血红蛋白水平与微量白蛋白尿之间存在显著负相关(ɼ = -0.28;p = 0.032)。

结论

本研究揭示了我们所研究环境中SCD儿童微量白蛋白尿相关因素,并强调了对SCD儿童早期筛查CKD标志物的必要性。需要进一步研究以确定纠正贫血和减少溶血在减轻SCD儿童微量白蛋白尿发生方面的潜在益处。

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本文引用的文献

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Predictors associated with sickle cell nephropathy: a systematic review.与镰状细胞肾病相关的预测因素:系统评价。
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