Correlates of iron deficiency among adult patients with sickle cell nephropathy at a tertiary health facility in Lagos, Nigeria: A cross-sectional study

Abstract

Background: Iron deficiency presents a muddled clinical picture in patients with sickle cell anemia (SCA). The picture is further complicated when these patients develop sickle cell nephropathy (SCN). This study aimed to identify the correlates of iron deficiency among adult patients with SCN in Lagos, Nigeria. Methods: This was a cross-sectional study conducted among adult patients with SCN who presented at the nephrology clinic of the tertiary health facility. Data on demographics, clinical history, laboratory investigations, and iron status were collected and analyzed using the Statistical Package for the Social Sciences (SPSS) version 28. Results: One hundred and nineteen adult patients with SCN were enrolled in the study. The mean age was 28.9 ± 9.5 years, and the majority were females. Iron deficiency was present in 36 (30.2%) subjects, while 7.6% had elevated iron status. Younger age and male sex were associated with iron deficiency state. Participants with an estimated glomerular filtration rate (eGFR) of ≥60 mL/min had a higher prevalence of iron deficiency (r = −0.28 P < 0.01/r = −0.32 P < 0.01). A logistic regression analysis showed no independent association between these factors and iron deficiency. Conclusion: This study showed that iron deficiency is common in adults with SCN, seen in one-third of participants. Therefore, although iron overload is frequently acknowledged as a significant issue in SCA, it should not be automatically assumed in cases where nephropathy is present. The study findings also highlight the need for routine screening for iron deficiency among SCN patients, especially among males, younger patients or those with an eGFR ≥60 mL/min, to optimize their management and improve their outcomes.