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Background <p>Albuminuria is an early marker of renal involvement in sickle cell disease (SCD) and is associated with progressive renal function decline. However, data on albuminuria in adults with SCD in sub-Saharan Africa remain limited. This study aimed to determine the prevalence of albuminuria and identify factors associated with albuminuria in adults with steady-state SCD in Kinshasa, Democratic Republic of the Congo.</p> Methods <p>We conducted a multicenter cross-sectional study involving 279 adults (aged ≥ 18 years) with steady-state SCD. Albuminuria was assessed using the urinary albumin-to-creatinine ratio (UACR) and classified according to KDIGO categories. Glomerular filtration rate (GFR) was directly measured by plasma iohexol clearance. Cardiac function was evaluated by Doppler echocardiography, and arterial stiffness was assessed using pulse wave velocity (PWV). Multivariable linear and logistic regression analyses were performed to identify factors associated with albuminuria.</p> Results <p>The overall prevalence of albuminuria was 29.1%, including 21.5% with KDIGO A2 and 7.5% with A3 albuminuria. In multivariable linear regression, higher PWV was independently associated with increased albuminuria (β = 2.086, 95% CI: 1.036–3.208; <i>p</i> &lt; 0.001), whereas lower systemic vascular resistance (SVR) was inversely associated with albuminuria (β = -0.311, 95% CI: -0.762 to -0.001 <i>p</i> = 0.029). In multivariable logistic regression, urinary α-1 microglobulin ≥ 12&#xa0;mg/L (aOR 3.01, 95% CI 1.80–4.02), recent vaso-occlusive crisis (aOR 2.71, 95% CI 1.22–4.21), LDH &gt; 246 IU/L (aOR 3.57, 95% CI 2.40–6.13), and SVR &lt; 700 dyn·s/cm⁵ (aOR 1.91, 95% CI 1.51–7.15) were independently associated with albuminuria.</p> Conclusions <p>Albuminuria was common in this cohort of adults with steady-state SCD and was associated with markers of hemolysis, tubular injury, recent vaso-occlusive events, and systemic hemodynamic alterations. These findings suggest that albuminuria may be associated with a broader pattern of cardiorenal vulnerability in adults with SCD.</p>

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Albuminuria and associated renal and hemodynamic factors in adults with steady-state sickle cell disease: a multicenter study with measured GFR

  • 期刊论文

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  • 发表日期：

    2026年7月31日

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  • Yannick Mompango Engole,
  • Justine Busanga Bukabau,
  • Yannick Mayamba Nlandu,
  • Aliocha Natuhoyila Nkodila,
  • Brady Makanzu,
  • Jean-Robert Rissassy Makulo,
  • François Musungayi Kajingulu,
  • Vieux Momeme Mokoli,
  • Marie-France Ingole Mboliasa,
  • Evariste Mukendi Kadima,
  • Chantal Zinga Vuvu,
  • Daddy Mbiso Liombo,
  • Jonathan Musa,
  • Blaise Nkolomoni,
  • Ange Ngonde,
  • Ernest Kiswaya Sumaili

摘要

Background

Albuminuria is an early marker of renal involvement in sickle cell disease (SCD) and is associated with progressive renal function decline. However, data on albuminuria in adults with SCD in sub-Saharan Africa remain limited. This study aimed to determine the prevalence of albuminuria and identify factors associated with albuminuria in adults with steady-state SCD in Kinshasa, Democratic Republic of the Congo.

Methods

We conducted a multicenter cross-sectional study involving 279 adults (aged ≥ 18 years) with steady-state SCD. Albuminuria was assessed using the urinary albumin-to-creatinine ratio (UACR) and classified according to KDIGO categories. Glomerular filtration rate (GFR) was directly measured by plasma iohexol clearance. Cardiac function was evaluated by Doppler echocardiography, and arterial stiffness was assessed using pulse wave velocity (PWV). Multivariable linear and logistic regression analyses were performed to identify factors associated with albuminuria.

Results

The overall prevalence of albuminuria was 29.1%, including 21.5% with KDIGO A2 and 7.5% with A3 albuminuria. In multivariable linear regression, higher PWV was independently associated with increased albuminuria (β = 2.086, 95% CI: 1.036–3.208; p < 0.001), whereas lower systemic vascular resistance (SVR) was inversely associated with albuminuria (β = -0.311, 95% CI: -0.762 to -0.001 p = 0.029). In multivariable logistic regression, urinary α-1 microglobulin ≥ 12 mg/L (aOR 3.01, 95% CI 1.80–4.02), recent vaso-occlusive crisis (aOR 2.71, 95% CI 1.22–4.21), LDH > 246 IU/L (aOR 3.57, 95% CI 2.40–6.13), and SVR < 700 dyn·s/cm⁵ (aOR 1.91, 95% CI 1.51–7.15) were independently associated with albuminuria.

Conclusions

Albuminuria was common in this cohort of adults with steady-state SCD and was associated with markers of hemolysis, tubular injury, recent vaso-occlusive events, and systemic hemodynamic alterations. These findings suggest that albuminuria may be associated with a broader pattern of cardiorenal vulnerability in adults with SCD.