Persistent proteinuria among sickle cell anaemia children in steady state in Ilorin, Nigeria

Sickle cell disease (SCD), the commonest single gene disorder amongst Nigerian children, may present as sickle cell nephropathy (SCN). SCN is detectable by persistent proteinuria, a “nephrotoxin” that contributes to progression of SCN to end stage renal disease. Unfortunately, screening for persistent proteinuria is an uncommon practice among Nigerian children with SCD, even when reduction of proteinuria is a proven renoprotective therapy. Dipstick urinalysis was done to detect persistent proteinuria (proteinuria of trace and above, on first contact and a month on follow-up in the same subject) among consecutive steady state sickle cell anaemia (haemoglobin SS confirmed using cellulose acetate paper electrophoresis) children attending sickle cell clinic at the University of Ilorin Teaching Hospital between October, 2004 and July, 2005. Subjects with persistent proteinuria were also assessed for estimated glomerular filtration rate (eGFR) using the method described by Schwartz et al. A total of 75 children aged between 1 to 17 years, comprising 35 males and 40 females, were studie. Proteinuria was found in 6 (8%) subjects (5 males, 1 female) and in 5 (6.7%) subjects (3 males, 2 females) on first contact and one month on follow-up, respectively. Persistent proteinuria was only seen in 3 (4%) male subjects (older than 10 years age) whose eGFR was not impaired. Although proteinuria occurred more commonly among male subjects than females on first contact and at follow-up, this observation was not statistically significant (p = 0.175 at first contact, p = 0.224 at follow-up). Proteinuria also occurred more among subjects older than 10 years of age at both contacts, this association was also not significant (p = 0. 071 on first contact, p value = 0.10 at follow-up). Although, a low prevalence of persistent proteinuria was found among the sickle cell anaemia children studied, its screening should become a routine to identify children who will benefit from antiproteinuric treatment.