A Study Of Renal Abnormalities In The Patient Suffering From Sickle Cell In Nepal

Objective:Numerous studies documented the renal abnormalities in the patient suffering from Sickle cell Disease in many countries in the world.However in Nepal sickle cell nephropathy is poorly studied.This work aims to analyze the various renal manifestations of sickle cell disease in children.Methods: This was a retrospective study conducted on children(n = 50)aged between 1 and 15 years admitted in the pediatric department of Kanti Baal General Hospital at Kathmandu,Nepal for sickle cell hemoglobinopathy.The Data were collected for a period of two years.The subjects(children)were of both sexes.To meet our objectives,several analysis and culture were made using,serum and/or urinary samples of each patient.Hematological tests of the serum,biochemical analysis of both urine and serum samples,urinary analysis including concentrations test,microscopic analysis,and dipstick analysis were effectuated.The values obtained were compared against their respective reference ranges.Results: There were 18 cases of SCA,28 cases of SCT and 4 cases of SaT.The age groups and gender did not differ significantly among different study groups.9(50%)of SCA and 2 of SCT had first crisis when they were below 3 years of age,while the remaining had their first crisis when they were older than 3 years of age,which was statistically significant(p<0.03).The frequency of hospitalization and blood transfusion was significantly more in SCA and SaT group when compared with SCT cases..Systolic blood pressure was found to be low(< 5th percentile)in 6(12%)children’s,while 43(86%)children had normal systolic blood pressure(5th-95 th percentile).This distribution was found to be significant(p < 0.000). All cases had diastolic blood pressure in normal range.The mean hemoglobin(p < 0.001)and hematocrit(p < 0.001)levels were significantly lower in SCA in comparison to SCT patients.Proportionally,SCA patients had significantly lower hemoglobin level in comparison to SCT group(p= 0.012).However,no difference was observed between the proportions and means of the various groups as regard to absolute platelet and total leukocyte counts.Nocturia was present in significantly higher proportion of patients of SCA(61.1%)in comparison to SCT(28.6%),(p < 0.028).Urinary albumin/creatinine ratio was significantly more in patients who experienced nocturia(p = 0.05).Conclusion: The findings of this study shows that SCD patients of nepal’s systolic blood pressure was found low and they suffered nocturia commonly,Urinary albumin/creatinine ratio was significantly more in these patients.By examining the abnormal clinical parameters,we can diagnose the renal abnormalities of SCD patient earlier.