E-Mail karger@karger.com Original Paper Med Princ Pract DOI: 10.1159/000361029 Degrees of Kidney Disease in Nigerian Adults with Sickle-Cell Disease John C. Aneke a, c Adegbola O. Adegoke d Anthony A. Oyekunle c Patrick O. Osho c Abubakra A. Sanusi e Emmanuel C. Okocha a Nancy C. Ibeh b Norah O. Akinola c Muheez A. Durosinmi c a Department of Haematology, Nnamdi Azikiwe University Teaching Hospital, and b Department of Medical Laboratory Science, Nnamdi Azikiwe University, Nnewi, and Departments of c Haematology, d Chemical Pathology and e Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria 19 (37%), 21 (41%) and 3 (6%) had stage 1, 2, 3 and 4 CKD, respectively. None of the subjects had stage 5 CKD. Conclu- sion: In this study, the adult subjects with SCD had various degrees of CKD. Adequate follow-up and active intervention are advocated to delay the onset of end-stage nephropathy. © 2014 S. Karger AG, Basel Introduction Sickle-cell disease (SCD) is a heterogeneous disorder affecting multiple organ systems in the body [1, 2]. In- deed, end-organ dysfunction has a huge impact on sur- vival, especially in young adults [3]. Recurrent vaso-oc- clusion [4], coupled with the haemodynamic changes of chronic anaemia lead to functional and structural chang- es in the kidneys. These morphological, laboratory and clinical changes arising from the effects of SCD on the kidneys constitute what has been described as sickle-cell nephropathy (SCN). They range from haematuria, vary- ing degrees of proteinuria and renal failure syndromes to glomerular and tubular abnormalities [5, 6] which may ultimately progress to chronic kidney disease (CKD) [7, 8]. End-stage kidney disease has been identified as the most severe presentation of SCN, with a huge impact on Key Words Chronic kidney disease · Creatinine clearance · Sickle-cell disease Abstract Objective: To study degrees of chronic kidney disease (CKD) using creatinine clearance in adult Nigerian patients with sickle-cell disease (SCD). Methods: One hundred SCD pa- tients, made up of 79 HbSS (homozygous haemoglobin S) patients and 21 HbSC (heterozygous haemoglobins S and C) patients, were investigated prospectively, along with 50 nor- mal controls. Their sociodemographic data, weight and drug history were documented. Each participant underwent dip- stick urinalysis, and creatinine clearance was calculated fol- lowing a 24-hour urine collection and serum creatinine mea- surement. They were categorized into stages of CKD based on the creatinine clearance. Results: Of the 79 HbSS patients, 14 (18%), 28 (35%), 33 (42%) and 4 (5%) had stage 1, 2, 3 and 4 CKD, respectively. In the HbSC group, 3 (14%), 9 (43%) and 9 (43%) patients had stage 1, 2 and 3 CKD, respectively. Pro- teinuria was noted in 16 (20%) HbSS patients but not in any of the HbSC patients. Of the subjects aged ≤24 years (n = 49), 9 (18%), 18 (37%), 21 (43%) and 1 (2%) had stage 1, 2, 3 and 4 CKD, respectively. Of those aged >24 years (n = 51), 8 (16%), Received: October 7, 2013 Accepted: March 3, 2014 Published online: April 16, 2014 Dr. J.C. Aneke Department of Haematology Nnamdi Azikiwe University Teaching Hospital, PMB 5025 Nnewi, Anambra State (Nigeria) E-Mail anekejc  @  ymail.com © 2014 S. Karger AG, Basel 1011–7571/14/0000–0000$39.50/0 www.karger.com/mpp his is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Un- ported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribu- tion permitted for non-commercial purposes only. Downloaded by: 154.68.222.1 - 5/13/2014 3:13:49 PM