Diagnostic accuracy of microalbuminuria among sickle cell children with nephropathy

Abstract

Objective: The aim of this study is to detect the diagnostic accuracy of microalbuminuria (MA) among sickle cell children with nephropathy. Materials and Methods: Five hundred and seven sickle cell homozygous children between 5 and 14 years of age group were enrolled after receiving written informed consent from the parents and/or caregiver. Children with preexisting kidney diseases, albuminuria, and taking any drugs that will affect renal function were excluded from the study. Sickle cell nephropathy (SCN) was diagnosed by using the National Kidney Foundation Kidney Disease Outcome Quality Initiative guidelines. Study Design: The study design involves diagnostic study Phase I. Statistical Analysis: Descriptive statistics were done using SPSS version 25.0 (IBM, NY, USA), and diagnostic statistics such as receiver operating characteristic curve (ROC) and others were done by Dxt version 1.0 software (BRTC, Vellore, India). Results: Of 507 patients, 268 (52.8%) were male and 239 (47.1%) were female. The mean age of the study population was 9.42 ± 2.56 years. Cutoff value of MA was ≥47 mg/day (sensitivity [Sn]: 73.9%, specificity [Sp]: 90.5% and area under curve was 0.841 [0.56, 0.91] with P = 0.001). Sn of MA was 76.1% (61.1%, 80.7%), Sp: 90.9% (87.8%, 93.5%), positive predictive value: 62.4% (52.2%, 71.8%), negative predictive value: 93.8% (91%–96%), likelihood ratio positive (LR+): 7.894 (5.672, 10.986), likelihood ratio negative (LR-): 0.312 (0.224, 0.436), odds ratio: 25.266 (14.277, 44.713) with diagnostic accuracy of 83.62%. Conclusions: MA can be used as a good screening tool for early detection of SCN. However, larger studies with a good level of evidence are awaited.

Keywords

• children
• microalbuminuria
• receiver operating characteristic curve
• sickle cell nephropathy