Introduction:
Albuminuria is frequently observed in patients with sickle cell disease (SCD) and can progress to chronic kidney disease. Sickle cell disease is also associated with glomerulopathy, which depends on multiple factors that remain to be elucidated. This study was to investigate the frequency and determinants of albuminuria according to sickle cell genotype type.
Methods:
Une étude analytique transversale multicentrique d’adultes atteints d’une drépanocytose stable a été menée à Kinshasa entre mars et décembre 2023. Les paramètres d’intérêt comprenaient les paramètres démographiques, cliniques, biologiques et mesures de la vitesse de l’onde de pouls (VOP) et échographie cardiaque. Le génotype était catégorisés comme homozygotes : HbSS, hétérozygotes : HbAS et HbSC ; albuminurie : un rapport albumine/créatinine urinaire (mg/g) : normal, < 30 ; Augmentation modérée : 30-300; ou fortement augmentée, > 300.
Results:
A total of 247 patients were included, 205 homozygous and 42 heterozygous. Albuminuria was prevalent in 50.5% of homozygous patients (44% moderately and 6.5% severely increased) and 56.1% of heterozygous patients (46.3% moderately and 9.8% severely increased). Multiple linear regression analysis showed that albuminuria was independently associated in the homozygous group with systolic blood pressure (SBP) (P=0.037), diastolic blood pressure (DBP) (p=0. 010), reduced haemoglobin (P=0.047), elevated GOT (P=0.019) and PWV (P=0.032); in the heterozygous group with SBP (p=0.023), DBP (p=0.019), elevated GOT (p=0.003). In the multivariate analysis, the factors associated with albuminuria in the homozygous group were age ≥ 30 years [aOR 2.36, (1.63-2.93), P = 0.037], skin ulcer [aOR 2.78, (1.90-3.53), p = 0.010], hypertension [aOR 2.19, (1.38-3.66), p = 0.038], CRP > 6 mg/L [aOR 3.34, (1.75-5.39), p = 0.033]. In the heterozygous group, two of the same factors as in the homozygous group were found, namely hypertension and CRP > 6 mg/L [aOR 3.19, (1.59-4.31), p = 0.009], [aOR 3.07, (2.11-6.70), p = 0.006] respectively. In addition to these 2 factors, there was a history of VOC [aOR 1.67, (1.23-2.32), p = 0.014].
Conclusions:
More than half of our patients with sickle cell disease had albuminuria, which was independently associated with hypertension and elevated CRP in both groups. Age ≥ 30 years and skin ulcer were specifically associated in the homozygous group while history of VOC in the heterozygous group.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.