Progression of Albuminuria in Sickle Cell Disease at the Clinical Hematology Department in Abidjan

Abstract

Introduction: Sickle cell disease (SCD) is the most common hemoglobinopathy worldwide. It is of significant public health importance in Sub-Saharan Africa. The SCD nephropathy is a major contributor to the morbidity and mortality. The Early detection and prevention of Albuminuria is vital for Nephro-prevention; an effective management tool for SCD. Aim: The present study showed albuminuria as a potential biomarker of sickle cell nephropathy and determine its progression and the associate factors for better prevention. Materials and Methods: This was a longitudinal, prospective, descriptive and analytical study conducted at the Cocody University Hospital Center from May 2023 to May 2025, involving children and adult sickle cell disease patients with albuminuria monitoring. Results: 392 sickle cell patients were recruited, 144 patients had albuminuria. The prevalence was 36.7% with a sex ratio of 0.45 and a mean age of 25.96 years. The SSFA2 form was the most representative. Albuminuria was associated with low hemoglobin levels, mostly between 4-6 g/dl. An albuminuria threshold >300 mg/24h at baseline was associated with an increased risk of persistent albuminuria PA. In multivariate analysis, macroalbuminuria was associated with anemia, young adult and higher levels of renal lesions; microalbuminuria was mainly associated with late childhood and adolescence, with rare renal lesions. 25.7% of cases developed (PA), which was associated with macroalbuminuria and poor therapeutic adherence. The decrease in glomerular filtration rate and Chonic Kidney Disease (CKD) in adults was associated with PA, but not with initial albuminuria. All 4 patients recorded deaded presented persistent albuminuria. Conclusion: The risk of eGFR decline and CKD in adults was associated with PA. Albuminuria in sickle cell disease progressed with age, and PA was also positively associated with characteristics and biomarkers of renal lesions.