ABSTRACT
Background: Sickle cell anaemia (SCA) is associated with a chronic inflammatory component; blood neutrophil to lymphocyte ratio (NLR) has been described as a marker of organ dysfunction and clinical outcome in diseases associated with systemic inflammation. Objective: To evaluate NLR in Nigerian SCA patients with nephropathy. Methods: Seventy-nine (79) SCA patients in steady state and 50 aged-matched controls were prospectively enrolled for this study. Full blood count and dip-stick macro-albuminuria were done for each participant and data was analyzed using descriptive and inferential statistics. The level of statistical significance was defined as p ≤ 0.05. Results: The NLR was significantly higher in cases compared with controls (1.49±0.76 vs. 1.20±0.34, P=0.01) and the ANC was significantly higher in those with NLR ≥ 3.0 compared with those with NLR <3.0 (12.22±5.26x109/L vs. 6.10±2.96x109/L, respectively, P<0.001). Between cases with and without macro-albuminuria and controls, the means of NLR was significantly different (P=0.024). Macro-albuminuria was present in 16 (21.9%) of cases (all of which had NLR <3.0), this was not significantly correlated with NLR (r=-0.99, P=0.71). Conclusion: No significant relationship was observed between NLR and SCA nephropathy.
ABSTRACT
To study degrees of chronic kidney disease [CKD] using creatinine clearance in adult Nigerian patients with sickle-cell disease [SCD]. One hundred SCD patients, made up of 79 HbSS [homozygous haemoglobin S] patients and 21 HbSC [heterozygous haemoglobins S and C] patients, were investigated prospectively, along with 50 normal controls. Their sociodemographic data, weight and drug history were documented. Each participant underwent dipstick urinalysis, and creatinine clearance was calculated following a 24-hour urine collection and serum creatinine measurement. They were categorized into stages of CKD based on the creatinine clearance. 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. Proteinuria was noted in 16 [20%] HbSS patients but not in any of the HbSC patients. Of the subjects aged 24 years [n = 51], 8 [16%], 19 [37%], 21 [41%] and 3 [6%] had stage 1, 2, 3 and 4 CKD, respectively. None of the subjects had stage 5 CKD. 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