Prevalence and factors associated with glomerular hyperfiltration among children aged 2 to 18 years with sickle cell anemia at Jinja Regional Referral Hospital.
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Date
2023-09
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Kampala International University
Abstract
Introduction: Even though progression in children’s care with SCD have raised, their prolonged-term survival is characterized by long-standing diseases such as long-standing kidney disease. Renal involvement occurs all the time of life of a patient with SCA and contribute greatly reduced life expectancy of patients with sickle cell disease, accounting for 16–18% of mortality.
The study aimed at determining the prevalence and factors associated with glomerular hyperfiltration among children aged 2 to 18 years with sickle cell anemia at Jinja Regional Referral Hospital (JRRH). The study also described the proportion of microalbuminuria among SCA children with glomerular hyperfiltration.
Methods: An analytic and descriptive cross-sectional hospital-based study was conducted among children with Sickle cell anemia. Consecutive enrolment of study participants was done until the sample size of 245 was achieved. The prevalence of glomerular hyperfiltration was analyzed as percentage with its corresponding 95% CI. To determine factors associated with glomerular hyperfiltration, bivariate and multivariate logistic regression were run. Both unadjusted (crude) odds ratios with their corresponding 95% confidence interval (CI) and adjusted OR with their corresponding 95% CI were reported. The proportion of microalbuminuria among study participants with glomerular hyperfiltration was determined as a fragment of participants with albuminuria and glomerular hyperfiltration over the number of study participants with glomerular hyperfiltration.
Results: The prevalence of glomerular hyperfiltration was 28.00%. The independent risk factors for glomerular hyperfiltration were age and severe anemia. Children who were in the age group of 14 – 16 years had 3.91 folds the risk of developing Glomerular Hyperfiltration (aOR 3.91, 95%CI 1.41-37.23, P=0.023) and children who had severe anemia were 9.47 folds the risk of developing Glomerular Hyperfiltration (aOR 9.47, 95%CI 1.57-57.05, P<0.001).
Conclusion: This study suggests that a considerable proportion of children in this population experience glomerular hyperfiltration. The results underscore the importance of considering age, and severe anemia in the management and care of these patients. This study suggests that a significant proportion of SCA children with glomerular hyperfiltration may be experiencing early kidney damage or dysfunction, as evidenced by the presence of MA.