Persistent hematuria among children with sickle cell anemia in steady state

Abstract

Introduction Persistent hematuria is a chronic complication of sickle cell anemia (SCA) which can progress to chronic kidney disease. The practice of early detection of persistent hematuria in children with SCA in steady state is important for timely intervention. Objective To determine the prevalence of persistent hematuria among children with sickle cell anemia in steady state and compare the result with that of a group of HbAA controls. The outcome will possibly strengthen the health policy on the need for regular screening for persistent hematuria in children with SCA. Methods Children with sickle cell anemia, aged 2–18 years in steady state, were recruited consecutively from the sickle cell clinic at the University of Nigeria teaching Hospital Enugu. The controls were similarly recruited from the children’s outpatient clinic. To determine persistent hematuria, dipstick urinalysis and microscopy were performed for both subjects and controls at enrollment and repeated after four weeks. Results Out of the 122 children with SCA studied, 5 (4.1%) had persistent hematuria. None (0%) of the 122 age- and gender-matched HbAA controls had persistent hematuria. This difference in prevalence of persistence between HbSS patients and HbAA controls was statistically significant ( p = 0.02). Conclusion Persistent hematuria still occurs significantly more among children with SCA, even among those in steady state. Routine urinalysis at follow-up visits in children with SCA is strongly recommended, as this will aid early detection and prompt management to prevent progression to chronic kidney disease.

Systematic Review of Genetic Modifiers Associated with the Development and/or Progression of Nephropathy in Patients with Sickle Cell Disease

“…Four to twelve percent of adults with SCD progress to kidney failure [1,8] but decreased GFR and kidney failure may already occur during childhood/adolescence [10]. Other manifestations include hemoglobinuria [11] and hematuria [12,13].…”

Surgical Haematuria: An Analysis of Causes in a Southern Nigerian State

“…Visible haematuria can sometimes be frightening. Non-visible haematuria associated with proteinuria is usually caused by medical conditions (renal disease) and is sometimes termed medical haematuria [6] [7]. Common causes of haematuria include trauma, tumours, infections, strictures, calculi and even exercise [1].…”