To Estimate the Prevalence and Risk Factors for Nephropathy in Patients with Steady-State Sickle Cell Anemia at A Tertiary Care Centre

Background: Sickle Cell Disease is a common inherited disorder associated with progressive multiorgan complications, including renal involvement. Sickle cell nephropathy (SCN) often begins in childhood and remains subclinical in early stages, making timely detection essential. The present study was undertaken to estimate the prevalence of nephropathy and identify associated risk factors among children with sickle cell anemia in steady state. Material and Methods: This hospital-based cross-sectional observational study was conducted over one year in the Department of Paediatrics at Chacha Nehru Bal Chikitsalaya, Indore. A total of 63 children aged 2–14 years with confirmed sickle cell anemia in steady state were included. Clinical data, laboratory investigations (urine analysis, renal function tests), and ultrasonographic findings were recorded. Statistical analysis was performed using SPSS, with p < 0.05 considered significant. Results: The prevalence of nephropathy was 20.6% (95% CI: 10.6%–30.6%). Among affected children, 6.3% had isolated hematuria, 6.3% had isolated proteinuria, and 7.9% had both. Renal function tests (serum urea, creatinine, eGFR) were normal in all participants, indicating early-stage disease. Increasing age was significantly associated with nephropathy (p = 0.009), with combined urinary abnormalities showing strong association (p = 0.020). Markers of disease severity, including hospitalisations, blood transfusions, and vaso-occlusive crisis episodes, were significantly higher in affected children (p < 0.001). Poor follow-up (p = 0.008) and poor drug compliance (p = 0.031 to <0.001) were important modifiable risk factors. Conclusion: Nephropathy is a common early complication in pediatric sickle cell anemia, strongly associated with age, disease severity, and treatment adherence. Routine urine screening is essential, as renal function tests may remain normal in early stages.

Keywords: Sickle Cell Anemia; Nephropathy; Hematuria; Proteinuria; Pediatric.