BACKGROUND Sickle cell disease causes microvascular occlusion in different vascular beds. In kidneys, it leads to occult glomerular dysfunction causing asymptomatic microalbuminuria, proximal tubulopathy causing hyposthenuria and increased free water loss and distal tubulopathy causing poor urine acidification. We studied the prevalence of various types of renal dysfunction, the ability of different tests to detect it at an early stage and the correlation of these parameters in children receiving hydroxyurea (HU). PROCEDURE Fifty-six children (sample size calculated using SAS9.2 package) attending paediatric clinical services in a tertiary care hospital between 2 and 12 years of age diagnosed by high-performance liquid chromatography (HPLC) were enrolled. Their demographic and laboratory data including renal and urine parameters were collected. Parameters like fractional excretion of sodium (FeNa), trans tubular potassium gradient (TtKg) and free water clearance (TcH2O) were derived by calculations. Data were analysed using IBM SPSS Version 21.0 and Microsoft Office Excel 2007. RESULTS We found a significant number of children to have microalbuminuria (17.8%), hyposthenuria (30.4%) and impaired renal tubular potassium excretion (TtKg) (81.3%). A significant correlation was found between the dose of HU with urine osmolality (p < 0.0005) and free water clearance (p = 0.002), while all parameters showed a significant correlation with compliance with HU. Derangement in urine microalbumin and TcH2O correlated significantly with low mean haemoglobin levels (<9 g/dl). CONCLUSION Renal dysfunction is common in children with SCD and can be detected early using simple urine parameters and can be prevented with an early and appropriate dosage of HU with good compliance.

中文翻译：

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印度镰状细胞病患儿肾小球功能障碍和肾小管病变的早期检测。

背景技术镰状细胞病导致不同血管床中的微血管闭塞。在肾脏中，它会导致隐匿性肾小球功能障碍，导致无症状的微量白蛋白尿，近端肾小管病变导致低尿酸和自由水丢失增加，以及远端肾小管病变导致尿液酸化不良。我们研究了接受羟基脲 (HU) 治疗的儿童中各种类型肾功能不全的发生率、不同测试在早期发现肾功能不全的能力以及这些参数的相关性。程序 56 名儿童（样本量使用 SAS9.2 包计算）在三级医院接受儿科临床服务，年龄在 2 至 12 岁之间，通过高效液相色谱法 (HPLC) 诊断。收集了他们的人口统计和实验室数据，包括肾脏和尿液参数。通过计算得出钠排泄分数 (FeNa)、反管钾梯度 (TtKg) 和游离水清除率 (TcH2O) 等参数。使用 IBM SPSS 21.0 版和 Microsoft Office Excel 2007 分析数据。 结果 我们发现大量儿童患有微量白蛋白尿 (17.8%)、低尿症 (30.4%) 和肾小管钾排泄 (TtKg) 受损 (81.3%)。HU 剂量与尿渗透压 (p < 0.0005) 和游离水清除率 (p = 0.002) 之间存在显着相关性，而所有参数均显示与 HU 依从性显着相关。尿微量白蛋白和 TcH2O 的紊乱与低平均血红蛋白水平 (<9 g/dl) 显着相关。