Prevalence and Risk Factors for Microalbuminuria in Children with Sickle Cell Disease at King Abdulaziz University Hospital: A Retrospective Cross-sectional Study.

Yahya A Alzahrani,Fatma Alzahrani,Joud E Alead,Osama Safdar,Hanan M Alsayyad,Khadijah M Aljahdali,Malak A Algarni,Yara A Alhjrsy,Maryam M Alnashri

doi:10.7759/cureus.6638

Abstract

Objectives: Previous studies have not addressed microalbuminuria in pediatric patients with sickle cell disease (SCD) in Jeddah, Saudi Arabia. This study aimed to determine the prevalence of microalbuminuria and to identify associated risk factors in children with SCD at King Abdulaziz University Hospital.Results: Overall, 42.5% of the patients enrolled were Saudi Arabian and 51% were male. The mean age was 12.4 years, and the highest percentage (40%) was in the age group of 15-18 years. The prevalence of microalbuminuria was 9.6%, and hematuria was present in 8% of cases. The percentage of patients with hematuria was significantly higher in the microalbuminuria group (22.6%) than in the nonmicroalbuminuria group (6.5%; P = 0.007). The percentage of patients with acute chest syndrome was also higher in the microalbuminuria group (26%) than in the nonmicroalbuminuria group (8%; P = 0.005). The percentage of patients with gallbladder stones was higher in the microalbuminuria group (13%) than in the nonmicroalbuminuria group (2.4%; P = 0.014). However, the mean number of blood transfusions was higher in the nonmicroalbuminuria group than in the microalbuminuria group (P = 0.002). Sickle cell nephropathy manifests as microalbuminuria, begins at an early age, occurs in all types of SCD, and is associated with disease severity.

Highlights

Sickle cell disease (SCD) is one of the most important autosomal recessive diseases
The percentage of patients with acute chest syndrome was higher in the microalbuminuria group (26%) than in the nonmicroalbuminuria group (8%; P = 0.005)
Sickle cell nephropathy manifests as microalbuminuria, begins at an early age, occurs in all types of SCD, and is associated with disease severity

Summary

Introduction

Sickle cell disease (SCD) is one of the most important autosomal recessive diseases. In the Kingdom of Saudi Arabia (KSA), the prevalence of the sickle cell trait ranges from 2% to 27%, and as many as 2.6% of affected individuals develop SCD. Renal impairment is a chronic complication of SCD and a major factor associated with mortality [2]. This association with mortality is stronger than that observed with an episode of acute stroke, a febrile episode with positive blood culture, acute chest syndrome, or severe acute anemia [3]. In SCD, microalbuminuria is one of the most common clinical manifestations of sickle cell nephropathy (SCN) [4,5], which appears to be associated with a more rapid deterioration in renal function [6]. The identification of microalbuminuria in a patient with SCD is a predictor of end-organ disease, including renal damage [10,11]. The early detection of microalbuminuria may represent an important early sign of renal disease [14]

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