Correlation of Microalbumin with Biochemical and Anthropometric Parameters in Sickle Cell Anaemia Patients in Southern Nigeria

Abstract

The renal manifestations of sickle cell anaemia (SCA) can range from haematuria and abnormal tubular function to massive proteinuria and end stage renal disease. This study was designed to screen for microalbuminuria in SCA patients and assess the coexistence of frequently documented biochemical changes and anthropometric parameters in sickle cell anaemia patients. This was achieved by determining the presence of microalbuminuria in these patients using Albumin Creatinine Ratio (ACR) in spot urine. A total of 68 asymptomatic sickle cell anaemia patients and 30 non sickle cell anaemia controls were used for the study. These patients were grouped into two: those with normal ACR and others with microalbuminuria using the ACR ≥ 3.0 mg/mmol which approximates 24hr urinary albumin excretion in mg. Results obtained showed a mean significant increase (P < 0.05) in plasma urea  in the SCA patients (6.43 ± 0.54 mmol/L) than in the control (3.33 ± 0.16 mmo/L). There was also a significant increase (P < 0.05) in ACR in the SCA patients (4.5± 0.24 mg/mmol) than in the control subjects (2.19 ± 0.10 mg/mmol). Packed cell volume(PCV) was significantly higher (P < 0.05) in the control subjects (40.65 ± 0.62) than in the SCA patients (23.48 ± 0.94). There was a significant positive correlation between ACR and plasma urea in SCA patients with nephropathy (n = 52; r = 0.58, P < 0.05) and in those without nephropathy (n= 16, r =0.36, P< 0.05).The relationship between ACR and PCV was a significant negative correlation in SCA patients with nephropathy (n = 52; r = -0.39, P < 0.05). Our analysis also indicated that there was a significantly higher waist hip ratio (WHR) and systolic blood pressure in sickle cell anaemia patients (0.89 ± 0.01, 120.39±1.56 mmHg; P < 0.05) than in the control (0.86 ± 0.01, 111.62 ± 1.97). Body mass index (BMI) was significantly lower in the SCA patients (P<0.05). The study also showed that the incidence of nephropathy amongst sickle cell anaemia patients in Southern Nigeria is 76.5%. Microalbuminuria is a common finding in SCA patients and monitoring of ACR will be important in detecting early onset of sickle cell nephropathy.