Nocturnal enuresis and albuminuria or proteinuria are markers of renal damage in sickle cell disease (SCD) and commonly develop early on in life. Proteinuria progresses with age, leading to chronic kidney disease in adulthood.
The aims of this study were to identify the prevalence of enuresis and albuminuria/proteinuria in paediatric patients with SCD and to determine the relationship between these and various demographic and clinical variables.
Methods A cross sectional study with qestionnaire-based interviews themed on nocturnal enuresis was undertaken for children with SCD. Results: Fifty-six patients were recruited to the study (27 females). Twenty patients (35.7%) met the DSM IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) criteria for nocturnal enuresis compared to 5% prevalence in children in the general population.
There was a significant association between enuresis and age, overactive bladder (OAB) symptoms, sleep-disordered breathing (SDB), painful crises and regular transfusions. Fourteen out of 29 patients (48.3%) with OAB symptoms reported nocturnal enuresis compared to six out of 27 patients (22.2%) who did not (p < 0.05). Of the patients reporting SDB, 48.6% were enuretic compared to 14.3% who did not (p < 0.01). Incidence of painful crises per month was higher for the enuretic group (2.29 vs. 0.88, p < 0.05). There were significantly more enuretic children in the 6–9 year age group (6/15) than the 1–15 and 16–17 year age groups (8/26 and 1/15 respectively, p < 0.05).
Conclusions Nocturnal enuresis and proteinuria are prevalent at an early age in many children with SCD. Early identification and initiation of treatment may delay onset of complications. Questioning parents on enuresis, OAB and SDB symptoms and undertaking regular urinalysis on younger age groups is a practical and cost-effective surveillance method.