Yannick Mompango Engolea,b, Jean-Robert Rissassy Makuloa, Yannick Mayamba Nlandua,b,
Aliocha Natuhoyila Nkodilac, Justine Busanga Bukabaua, Brady Makanzub,d, Yannick Mvitab,d,
Jean Michel Mavungub, François Musungayi Kajingulua, Vieux Momeme Mokolia, Augustin
Luzayadio Longoa, Marie-France Ingole Mboliasaa, Evariste Mukendi Kadimaa, Chantal Vuvu
Zingaa, Clarisse Nsenga Nkondia, Jonathan Musab, Cedric Kabemba Ilungaa, Raggue
Mvibudulua, Blondy Mvete Mansonia, Beudin Lukokia, Nazaire Mangani Nsekaa and
Ernest Kiswaya Sumailia

 

ABSTRACT

Chronic kidney disease is a major complication of sickle cell disease (SCD), but early kidney injury frequently occurs  despite preserved or increased glomerular filtration rate (GFR), potentially limiting the usefulness of conventional kidney failure prediction tools.
We evaluated whether the Kidney Failure Risk Equation (KFRE) adequately reflects renal vulnerability in adults with SCD. In this multicenter cross-sectional study conducted in Kinshasa, Democratic Republic of the Congo, 241 adults with stable SCD underwent iohexol-measured GFR (mGFR) and albuminuria assessment. Renal risk was classified
according to KDIGO criteria. The KFRE was calculated overall and in participants with CKD stage ≥3. Multivariable logistic regression identified factors independently associated with moderate-to-high renal risk. Overall, 35.7% of participants had moderate-to-high KDIGO renal risk. Despite this burden of renal risk, KFRE estimates
remained very low overall and increased only in participants with CKD stage ≥3 (median risk: 5.98% at 2 years and 10.14% at 5 years). Increased renal risk was independently associated with vaso-occlusive crises (aOR 2.80, p = 0.012), leg ulcers (aOR 1.90, p = 0.030), stroke (aOR 2.66, p = 0.035), elevated LDH >220 U /L (aOR 3.19, p = 0.006), CRP ≥6 mg/L (aOR 3.04, p = 0.024), AST >40 IU/L (aOR 2.60, p = 0.002), and tricuspid regurgitant velocity ≥2.5 m/s (aOR 1.81, p = 0.041). More than one-third of adults with SCD had moderate-to-high renal risk despite preserved GFR. The discordance between KDIGO renal risk and KFRE estimates suggests that KFRE may underestimate early renal vulnerability in SCD. Measured GFR combined with albuminuria may improve early renal risk stratification and warrants prospective validation.

 

Renal Failure
2026, VOL. 48, NO. 1, 2699576

https://doi.org/10.1080/0886022X.2026.2699576

CONTACT Yannick Mompango Engole yannickengole@yahoo.fr, yannickengole22@gmail.com Nephrology Unit, Kinshasa University
Hospital, University of Kinshasa, Democratic Republic of the Congo.