Abstract
IntroductionHaematuria is one of the clinical manifestations of sickle cell nephropathy. Although dipstick urinalysis detects haemoglobin and by extension haematuria; it does not confirm haematuria. Urine sediment microscopy confirms haematuria and constitutes a non-invasive “renal biopsy”. The need to correlate dipstick urinalysis and urine sediment microscopy findings becomes important because of the cheapness, quickness and simplicity of the former procedure.MethodsDipstick urinalysis and urine sediment microscopy were carried (both on first contact and a month after) among consecutive steady state sickle cell anaemia children attending sickle cell clinic at the University of Ilorin Teaching Hospital between October 2004 and July 2005.ResultsA total of 75 sickle cell anemia children aged between 1-17 years met the inclusion criteria. Haematuria was found in 12 children (16.0%) and persistent haematuria in 10 children 13.3%. Age and gender did not have significant relationship with haematuria both at first contact (p values 0.087 and 0.654 respectively) and at follow-up (p values 0.075 and 0.630 respectively). Eumorphic haematuria was confirmed in all the children with persistent haematuria with Pearson correlation +0.623 and significant p value of 0.000.ConclusionThe study has revealed a direct significant correlation for haematuria detected on dipstick urinalysis and at urine sediment microscopy. It may therefore be inferred that dipstick urinalysis is an easy and readily available tool for the screening of haematuria among children with sickle cell anaemia and should therefore be done routinely at the sickle cell clinics.
Highlights
Haematuria is one of the clinical manifestations of sickle cell nephropathy
If significant correlation does exists between dipstick urinalysis and urine sediment microscopy in the detection of haematuria, dipstick urinalysis may suffice in identifying patients with haematuria, who may further benefit from further renal functions tests including glomerular filtration rate assessment
There was a significant positive correlation between haematuria found on dipstick urinalyses and that of urine sediment microscopy Table 4
Summary
Haematuria is one of the clinical manifestations of sickle cell nephropathy. dipstick urinalysis detects haemoglobin and by extension haematuria; it does not confirm haematuria. Conclusion: The study has revealed a direct significant correlation for haematuria detected on dipstick urinalysis and at urine sediment microscopy. It may be inferred that dipstick urinalysis is an easy and readily available tool for the screening of haematuria among children with sickle cell anaemia and should be done routinely at the sickle cell clinics. Sickle cell nephropathy is an important cause of morbidity and mortality in patients with sickle cell anaemia [1] It manifests clinically as proteinuria with or without nephrotic syndrome, immune-complex glomerulonephritis, progressive renal failure, impaired urinary concentration ability, incomplete distal tubular acidosis and haematuria [2]. Urine sediment microscopy is useful in this regard By detecting erythrocytes, it confirms a positive dipstick reaction as haematuria. If significant correlation does exists between dipstick urinalysis and urine sediment microscopy in the detection of haematuria, dipstick urinalysis may suffice in identifying patients with haematuria, who may further benefit from further renal functions tests including glomerular filtration rate assessment
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