RELATIONSHIP BETWEEN SICKLE CELL NEPHROPATHY AND SOME BIOCHEMICAL MARKERS OF HAEMOLYSIS AMONGST PATIENTS WITH SICKLE CELL ANAEMIA IN KANO, NORTHWESTERN NIGERIA

Introduction

Advancements in the care of patients with sickle cell anaemia have led to significant improvement in survival with many patients reaching adulthood. As they age, long-term complications of the disease manifest in them, notable amongst which is nephropathy which is one of the leading causes of morbidity and mortality in them. There is limited information about sickle cell nephropathy and some biochemical markers of haemolysis that can detect it early in our setting. This study aimed to determine the relationship between some indirect markers of haemolysis and sickle cell nephropathy.

Methodology

The study was a descriptive cross-sectional one where 204 adolescent and adult patients with sickle cell anaemia attending the clinic of AKTH Kano were recruited. An interviewer-administered questionnaire was utilized. Blood samples were taken for determination of serum bilirubin, LDH, and reticulocyte count. Spot urine was used to quantitatively determine albumin to creatinine ratio. Data collated was analyzed using SPSS version 22.0. P-value <0.05 was considered significant.

Result

Two hundred and four (204) participants were enrolled in to the study. Their mean age was 19.6±5years. Females were the majority 131/204 (64.2%). The median (IQR) serum lactate dehydrogenase, bilirubin, direct bilirubin, and reticulocyte count were 607.0(487.3-758.5) U/L, 54.5(37.0-119.0) umol/L, 16.0(11.3-29.0) umol/L and 4.0(3.0-8.4%) respectively. Sickle cell nephropathy was found in 29/204 (14.2%). There were positive significant associations between sickle cell nephropathy with raised serum bilirubin and serum lactate dehydrogenase (p-value = 0.02 and 0.032 respectively).

Conclusion

Sickle cell nephropathy is common amongst patients with sickle cell anaemia and raised serum bilirubin and lactate dehydrogenase are predictors of sickle cell nephropathy.

Pollution assessment of the lower basin of Lakes Kainji/Jebba, Nigeria: heavy metal status of the waters, sediments and fishes

The objective of this investigation was to examine the heavy metal status of the lower basin of Kainji dam (used for hydroelectricity generation), which includes Lakes Kainji/Jebba, Nigeria, and the potential for human exposure to heavy metals from eating fish caught in the lakes. Water, sediments and fish were sampled from the lakes and evaluated for As, Cu, Co, Cr, Fe, Hg, Mn, Ni, Pb, Sb, Ti, V and Zn using the EDXRF technique. Fe and Mn were found to be present at high mean concentrations in the water (13 and 9 microg L(-1)), sediment (7,092 and 376 microg g(-1)) and fish (11.4 and 4.6 microg g(-1)) samples. Sb (3.2 microg L(-1)), Ti (4.1 mug L(-1)), Cr (2.2 microg L(-1)), Co (1.2 microg L(-1)), Cu (1.3 microg L(-1)) and Pb (1.2 microg L(-1)) in the water samples and Sb (29 microg g(-1)), Ti (27 microg g(-1)), V (27 microg g(-1)), Cr (27 microg g(-1)), Co (40 microg g(-1)), Ni (33 microg g(-1)), Cu (25 microg g(-1)), Zn (59 microg g(-1)) and Pb (19 microg g(-1)) in the sediment samples were found to be of medium mean concentrations. The other metals were present at trace levels (<1 microg), including As and Hg in the fish and sediment samples. There was an appreciable increase in metal concentrations in going from the water to the sediment samples. The probable source of the pollutants is anthropogenic, arising from agricultural activities, corrosion/abrasion of the ferrous steel material and additives in the lubricants and insulation used for auxiliary services on the turbine floor of the dam constructed on the lakes. However, natural geological sourcing from the underlying lake rock cannot be totally ignored, particularly the high levels of Fe and Mn in the sediment samples. The potential risk for human exposure to these metals emanates from the fish caught in the lakes and subsequently consumed, as there are already significant levels of these metals in the two fish species analysed, Tilapia (Oreochromis niloticus) and Chrysicthys (Chrysicthys auratus).