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Renal status of children with sickle cell disease in Accra, Ghana
1PricewaterhouseCoopers (Ghana) Limited, PMB CT 42 Accra, Ghana.
Insights
Sickle cell disease (SCD) in Ghanaian children shows early signs of kidney damage, including proteinuria. Routine urinalysis can help detect and manage this early renal impairment in SCD patients.
Area of Science:
- Pediatric Nephrology
- Hematology
- Public Health
Background:
- Sickle cell disease (SCD) affects 2% of children in West Africa, impacting organ function, particularly the kidneys.
- Limited data exists on the renal status of children with SCD in Ghana.
- SCD can lead to growth and developmental issues, alongside organ damage.
Purpose of the Study:
- To assess the renal status of children with sickle cell disease (SCD) in a steady state.
- Investigate early signs of nephropathy in pediatric SCD patients in Ghana.
Main Methods:
- A cross-sectional case-control study was conducted.
- 357 children with SCD and 70 healthy HbAA siblings (controls) participated.
- Data included socio-demographics, clinical data, dipstick urinalysis, and renal ultrasonography.
Main Results:
- Urinalysis revealed higher rates of leucocyturia, proteinuria, and haematuria in SCD cases compared to controls.
- Proteinuria was observed in SCD children as young as 2 years, increasing with age.
- Renal ultrasound findings were normal in all examined participants.
Conclusions:
- Urinary abnormalities indicative of nephropathy are present early in Ghanaian children with SCD.
- Routine dipstick urinalysis screening is recommended for early detection and intervention to prevent renal impairment.
- Prompt management can help limit long-term kidney damage in pediatric SCD patients.
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 Teaching 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% versus 5.7% (χ2=62.5 and the p=0.000)), isolated proteinuria 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 2 yrs. old. Proteinuria prevalence increased with age, , occurring in 5.7% of cases aged 9-11yrs. and 20.6% of cases aged 12 yrs. Two-thirds of the proteinuria cases were aged 9-12 yrs., of whom 50% were aged 12 yrs. Renal ultrasound findings were normal in all those examined.
Conclusion:
Urinary abnormalities suggesting nephropathy 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.
