Evaluation of Glomerular functions in Patients with SCA in Maiduguri North-eastern Nigeria: a recommendation for early assessment and detection of dysfunction in a resource-poor setting

Background: Sickle cell anaemia (SCA) is a disorder of Mendelian autosomal recessive inheritance, characterised by abnormal haemoglobin synthesis resulting in multi-systemic manifestations. The kidneys are largely affected by this disorder, but overt features of kidney disease mostly manifest after the second decade, even though insult and sub-clinical features may occur during childhood. Unfortunately, investigating these sub-clinical features is not routinely done in resource-scarce settings, partly due to the low socioeconomic status of most of our patients and the overwhelmed health care workers. Objectives: To investigate glomerular dysfunction in children with SCA in the context of the resource-poor setting. Methodology: This cross-sectional study was conducted at the University of Maiduguri Teaching Hospital (UMTH), over 6 months. One hundred and ten SCA (Hb SS) children aged 3 – 14 years in steady-state constituted the cases, while 110 non-SCA (Hb AA) age and sex-matched, apparently healthy children formed the control. Anthropometry, blood pressure, urinalysis and serum creatinine of the subjects was done. Glomerular filtration rate (GFR) was estimated using the Schwartz formula. Results: The mean systolic blood pressure (SBP) ± SD of the cases and controls were 96.8±9.34mmHg and 99.14±13.44mmHg respectively, (p = 0.13). The mean diastolic BP ± SD of the cases and controls were 60.18±6.85mmHg and 64.35±8.23mmHg respectively, (p = 0.0001). Glomerular filtration rate was significantly higher among the cases than the controls, 126±32ml/min/1.73m2 and 93±16ml/min/1.73m2 respectively (p