Renal Involvement in Patients with SS and SC Sickle Cell Disease Followed at the Clinical Hematology Department of Aristide Le Dantec Hospital

Abstract

Introduction : Renal complications are frequent and often early in patients with major sickle cell syndromes. However, the existing literature on this topic remains limited. The aim of this study was to screen for renal abnormalities and to describe the epidemiological, clinical, and paraclinical profiles of SS and SC sickle cell patients followed at Aristide Le Dantec Hospital (HALD). Patients and Methods : This was a cross-sectional, descriptive, and analytical study conducted over five months in the Clinical Hematology and Nephrology departments at HALD. All regularly followed SS and SC sickle cell patients were included. Each patient underwent a full clinical examination, urine dipstick test, and serum urea and creatinine measurement. Renal ultrasound was systematically performed. Data were analyzed using SPSS version 18. Results : Thirty-two patients were screened. Sixteen patients had renal involvement, representing a hospital prevalence of 50%. The average age of the patients was (32.21 ± 12.29) years with a sex ratio of 0.77. Fourteen patients (87.5%) were SS and two (12.5%) were SC. Clinically, six patients (37.5%) were hypertensive, twelve (75%) had clinical anemia, and two patients (12%) had renal-type edema. Fourteen patients (87.5%) had proteinuria ≥ 0.5 g/24h. Leukocyturia and hematuria were found in 36.4% and 12.5% of cases, respectively. Four patients had renal failure, including one at stage 4. Renal biopsy was performed in four patients and revealed focal segmental glomerulosclerosis in one patient, minimal change disease in two patients, and glomerular congestion in one patient. High blood pressure was the only poor prognostic factor found in our study. Conclusion: Our study supports international recommendations for the systematic screening of renal abnormalities in sickle cell patients with urine dipstick testing and GFR estimation. The high prevalence in our study necessitates early screening and management strategies for patients with major sickle cell syndromes.