Yannick Mompango Engole1,4 · Jean Robert Rissassi Makulo1 · Justine Busanga Bukabau1 ·
Yannick Mayamba Nlandu1,4 · Brady Makanzu2,4 · Yannick Mvita2,4 · Aliocha Nkodila1 ·
François Musungayi Kajingulu1 · Vieux Momeme Mokoli1 · Augustin Luzayadio Longo1 ·
Marie France Ingole Mboliasa1 · Clarisse Nsenga Nkondi1 · Daddy Mbiso Liombo3 · James Kalunga4 ·
Blaise Nkolomoni5 · Ange Ngonde6 · Ernest Kiswaya Sumaili1
Abstract
Albuminuria, which depends on multiple factors, is common in patients with sickle cell disease and can progress to
chronic kidney disease. In this study, we investigated the frequency and determinants of albuminuria according to sickle cell disease genotype. This multicentre cross-sectional analytical study of adults with stable sickle cell disease was conducted in Kinshasa. Genotypes were categorised as follows: homozygous, HbSS; heterozygous, HbAS; albuminuria, urinary albumin/creatinine ratio (mg/g): grade A1, < 30; grade A2:30–300; or grade A3, > 300. In total, 247 patients with sickle cell disease were included: 205 homozygous and 42 heterozygous. Albuminuria was prevalent in 50.5% of homozygous and 56.1% of heterozygous patients. The multivariate analysis revealed that the factors independently associated with albuminuria in the homozygous group were age ≥ 30 years (p = 0.037), leg ulcers (p = 0.010), hypertension (p = 0.038), and C-reactive protein level > 6 mg/L (p = 0.033). In the heterozygous group, only hypertension (p = 0.009), C-reactive protein > 6 mg/L (p = 0.006) and a history of vaso-occlusive crisis (p = 0.014) emerged as factors independent factors.
More than half of patients with sickle cell disease had albuminuria, which was independently associated with hypertension and inflammation in both groups. Furthermore, there was also an association between in albuminuria and age ≥ 30 years, manifestations of vasculopathy in the homozygous group and a history of vaso-occlusive crisis in the heterozygous group.
Keywords Albuminuria · Genotype · Sickle cell disease · Steady state