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Genotype-dependent albuminuria in adult sickle cell disease in Kinshasa

Yannick Mompango Engole1,2, Jean Robert Rissassi Makulo3, Justine Busanga Bukabau3

  • 1Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa,, Democratic Republic of the Congo. yannickengole22@gmail.com.

Annals of Hematology
|June 30, 2025
PubMed

Insights

Albuminuria is common in sickle cell disease (SCD) patients, affecting over half regardless of genotype. Hypertension and inflammation are key risk factors for albuminuria in SCD.

Area of Science:

  • Nephrology
  • Hematology
  • Public Health

Background:

  • Albuminuria is a common complication in sickle cell disease (SCD) and a predictor of chronic kidney disease.
  • Understanding the determinants of albuminuria across different SCD genotypes is crucial for early intervention and management.

Purpose of the Study:

  • To investigate the frequency and independent determinants of albuminuria in adults with sickle cell disease (SCD) based on their genotype (HbSS and HbAS).

Main Methods:

  • A multicentre cross-sectional analytical study was conducted in Kinshasa involving 247 adults with stable SCD.
  • Patients were classified by genotype (homozygous HbSS, heterozygous HbAS) and albuminuria status using the urinary albumin/creatinine ratio.
  • Multivariate analysis was used to identify factors independently associated with albuminuria in each genotype group.

Main Results:

  • Albuminuria was prevalent in 50.5% of homozygous (HbSS) and 56.1% of heterozygous (HbAS) patients.
  • In HbSS patients, albuminuria was associated with age ≥ 30 years, leg ulcers, hypertension, and elevated C-reactive protein (> 6 mg/L).
  • In HbAS patients, albuminuria was associated with hypertension, elevated C-reactive protein (> 6 mg/L), and a history of vaso-occlusive crisis.

Conclusions:

  • Over half of patients with sickle cell disease (SCD) exhibit albuminuria, irrespective of genotype.
  • Hypertension and inflammation (indicated by elevated C-reactive protein) are independent risk factors for albuminuria in both HbSS and HbAS genotypes.
  • Additional factors like age and vasculopathy manifestations (leg ulcers) in HbSS, and vaso-occlusive crisis history in HbAS, are also associated with albuminuria.

Keywords:
AlbuminuriaGenotypeSickle cell diseaseSteady state

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