Pediatric nephrology (Berlin, Germany) · 2026
Prevalence and determinants of early markers of kidney damage in homozygotic sickle cell patients in the DR Congo: Update.
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Betukumesu Kabasele Dieumerci, Aloni Michel, Makembi Bunkete Arriel, Kajingulu François, Lumbala Kabuyi Paul, Kazadi Orly, Nganga Nkanga Mireille Solange, Bodi Mabiala Joseph, Mikobi Tite, Longo Mbenza Benjamin, Tshiasuma Pipo Michel, Gini Ehungu Jean Lambert
Аннотация
BACKGROUND: Sickle cell nephropathy is a common complication of sickle cell disease that begins in childhood and can progress silently to chronic kidney disease. In the Democratic Republic of Congo (DRC), data on early kidney damage in children with sickle cell disease remain limited. In 2017, studies conducted in the same context reported separately on the prevalence of microalbuminuria and glomerular hyperfiltration (GHF). This study aimed to update the prevalence of albuminuria and GHF and to determine their associated factors in children with sickle cell disease in the DRC.
METHODS: We conducted a cross-sectional study including 175 children with sickle cell disease, followed up in four hospitals in Kinshasa. High albuminuria and GHF, the main evaluation criteria, were defined respectively by an albuminuria/creatinine ratio (ACR) ≥ 30 mg/g and an estimated glomerular filtration rate (eGFR) > 130 ml/min/1.73 m2 in girls and > 140 ml/min/1.73 m2 in boys, according to the Schwartz formula.
RESULTS: Among the 175 children included, 28.5% had high albuminuria and 38.3% had GHF. Factors significantly associated with early renal involvement were frequent blood transfusions (≥ 9/year), recurrent vaso-occlusive crises (≥ 3/year), low fetal hemoglobin levels (< 15%), and markers of hemolysis (LDH > 400 IU/L and elevated indirect bilirubin). These results reflect a high persistence of early renal impairment nearly nine years after the first data were published.
CONCLUSIONS: Early markers of kidney damage remain very common in children with homozygous sickle cell disease in the DRC. This persistence highlights the lack of effective kidney prevention strategies and the urgent need for systematic screening using simple and accessible tools in resource-limited settings.
METHODS: We conducted a cross-sectional study including 175 children with sickle cell disease, followed up in four hospitals in Kinshasa. High albuminuria and GHF, the main evaluation criteria, were defined respectively by an albuminuria/creatinine ratio (ACR) ≥ 30 mg/g and an estimated glomerular filtration rate (eGFR) > 130 ml/min/1.73 m2 in girls and > 140 ml/min/1.73 m2 in boys, according to the Schwartz formula.
RESULTS: Among the 175 children included, 28.5% had high albuminuria and 38.3% had GHF. Factors significantly associated with early renal involvement were frequent blood transfusions (≥ 9/year), recurrent vaso-occlusive crises (≥ 3/year), low fetal hemoglobin levels (< 15%), and markers of hemolysis (LDH > 400 IU/L and elevated indirect bilirubin). These results reflect a high persistence of early renal impairment nearly nine years after the first data were published.
CONCLUSIONS: Early markers of kidney damage remain very common in children with homozygous sickle cell disease in the DRC. This persistence highlights the lack of effective kidney prevention strategies and the urgent need for systematic screening using simple and accessible tools in resource-limited settings.