Published in PLOS One on 2026-04-30, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Angela Esohe Adeoti-Lawani, Gabriel Obiorah Ezeh, Elizabeth Eberechi Oyenusi, Chris Imokhuede Esezobor
Source: PLOS One • DOI 10.1371/journal.pone.0347556
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Persistent proteinuria is an early and modifiable marker of kidney damage. Although Nigeria has the highest burden of sickle cell anaemia (SCA) globally, the prevalence of proteinuria is unknown largely because many of the studies only determined proteinuria in a single urine sample or used less sensitive methods, such as dipstick. Unlike dipstick screening, quantitative urine protein-creatinine ratio allows more accurate detection of low-grade proteinuria.
To determine the prevalence and determinants of persistent proteinuria among children with SCA.
Children with SCA and age and sex-matched controls attending a publicly funded hospital in central Nigeria were consecutively enrolled. Proteinuria was determined at the first visit using the spot urine protein creatinine ratio and repeated at least 3 months afterwards for those with proteinuria. In addition, serum creatinine, full blood count, and fetal hemoglobin were determined at the first visit. Persistent proteinuria was defined as a urine protein-to-creatinine ratio ≥0.2 at both visits over a follow-up period of at least 3 months. Participants were classified based on the presence or absence of persistent proteinuria, and baseline characteristics were compared using within-group distributions for categorical variables with appropriate statistical tests.
One hundred and forty-nine children, each with SCA and controls, were enrolled, respectively. The median (IQR) age of the study participants was 9.0 (6.0) years for both groups, with 65% being males. Persistent proteinuria occurred in 35 (23.5%) children with SCA versus 4 (2.7%) controls (p-value < 0.01). Children with persistent proteinuria had a lower level of fetal hemoglobin. (adjusted OR 0.583, 95% C.I 0.473–0.719).
About a quarter of children with SCA had persistent proteinuria, an early and modifiable marker of chronic kidney disease.
Introduction
Children who have sickle cell disease (SCD), particularly SCA, experience chronic hemolysis and repeated vascular obstructions, resulting in acute clinical events and long-term organ involvement [1]. Kidney diseases in children with SCA have been recognized as significant contributors to morbidity and mortality [2]. In Nigeria, up to 18.5 to 27.5% of children with SCA have been reported to have kidney disease [3,4].
Screening for kidney disease can be done by simple non-invasive measures, such as the detection of albuminuria or proteinuria using a urine dipstick or by quantitative measurement of urine albumin or protein [5]. Normal urinary protein excretion in healthy children is less than 150 mg/24hrs or less than 4 mg/m2/hr [6]. Proteinuria is a urine-protein creatinine ratio of ≥ 0.2 (more than 0.5 for children 6–24 months of age) in a spot urine sample or more than 4 mg/m2/hr in a timed urine sample [7,8]. Protein in urine of 1g/m2/day or a urine-protein-creatinine ratio of more than 2 is termed nephrotic range proteinuria [6].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Angela Esohe Adeoti-Lawani, Gabriel Obiorah Ezeh, Elizabeth Eberechi Oyenusi, Chris Imokhuede Esezobor. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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