Proteinuria among adult sickle cell anemia patients in Nigeria

Background/Objective : The life expectancy of patients with sickle cell anemia (SCA) has improved with modern medical care, and this has led to frequent observation of various chronic complications of the disease including abnormalities in renal function. Proteinuria is not only a marker of renal disease but is also a predictor of disease progression. This screening study was aimed at evaluating the prevalence of proteinuria among adult SCA patients in Kano, Nigeria, which has not been reported previously.
Material and Methods : A total of 200 adult SCA patients were studied. They consisted of 100 men and 100 women. Blood was collected for the assay of serum urea, sodium, potassium, chloride, bicarbonate, and creatinine and estimated glomerular filtration rate (eGFR) was determined using the Cockcroft-Gault formula. Urine dipstick test for the presence of proteinuria and other abnormalities was done, and 24-hour urine protein was measured in those with significant proteinuria.
Results : Mean age of the male patients was 25.1 ± 1.0 years, whereas the mean age of the female patients was 22.8 ± 4.2 years. Twenty eight percent (32 males, 24 females) of the subjects were observed to have significant proteinuria. The mean estimated eGFR of the males was 88 ± 19.6 ml/min while that of the females was 92 ± 10.2 ml/min. The male SCA patients with proteinuria had a mean eGFR of 70 ± 6.9 ml/min, whereas the female SCA patients with proteinuria had mean eGFR of 101 ± 2.5 ml/min. Among the male patients with proteinuria, 50% had chronic kidney disease (CKD).
Conclusion : Proteinuria which is a marker of renal insufficiency is common among adult SCA patients, and routine screening for proteinuria may help detect those at increased risk of renal disease. CKD prevalence is high among SCA patients with significant proteinuria.