Burden And Risk Factors Of Chronic Kidney Disease In Children With Sickle Cell Anaemia Aged 5 – 16 Years At The University Teaching Hospital, Lusaka - Zambia

Nchimunya Machila, Monahani M Sinadambwe, Chishala Chabala, Chisambo Mwaba, Catherine Chunda-Liyoka

Abstract


Background: Improved medical care has led to improved life expectancy of sickle cell anaemia (SCA) patients hence complications associated with SCA such as chronic kidney disease (CKD) are being seen more frequently with over 30 % of paediatric SCA patients said to have CKD in Africa.

Purpose: This study sought to determine the burden and risk factors of CKD in paediatric patients seen at UTH in Lusaka, Zambia.

Methodology: This was a prospective cross - sectional study of 197 children aged 5 to 16 years with SCA at the UTH - Lusaka conducted from August 2014 to July 2015. Demographic and clinical data were collected using a structured questionnaire. Urine and blood samples were used to determine the urine albumin creatinine ratio (ACR) and full blood count /blood biochemistry respectively. CKD was defined and determined using the Kidney Disease Outcome Quality Initiative 2012 guidelines. Data was analyzed using SPSS version 21. Chi square and t test were used to compare proportions between groups. Relation between study variables and CKD were examined using logistic regression.

Results: The mean age of the participants was 9.6 years (SD ±3.6) with a male to female ratio was 1:1. The prevalence of CKD among the study participants was 36 %. Low haemoglobin and elevated mean corpuscular volume (MCV) were associated with CKD-AOR 0.62, 95% CI; 0.46-0.84 and 1.04, 95% CI; 1.01 – 1.08 respectively. Recurrent admissions (due to VOCs, severe anaemia and febrile illness) were also risk factors associated with CKD- AOR 0.52, 95% CI; 0.27-0.98.                                                                                                         

Conclusions: The prevalence of CKD among the SCA patients is high -36% with lower haemoglobin and elevated MCV being risk factors for developing CKD.


Keywords


Chronic kidney disease, sickle cell anaemia, Nephropathy.

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