The Diagnostic Implications of Spot Urinalysis of Subjects from a Ghanaian Sickle Cell Clinic

Sickle cell disease persons are prone to develop nephropathy due to the hemoglobinopathy, infection or drug therapy. Any indication of nephropathy or urinary tract abnormality can be ascertained, using urine analysis. In this study, spot urine samples were collected from 294 SCD subjects, aged 5 to 20 years, for macroscopic and microscopic examinations. Parameters examined included urine appearance; color and cloudiness, dipstick-identifiable parameters, such as presence of bilirubin, uro- bilinogen, blood, protein, glucose and ketones. Other parameters were presence of pus cells and epithelial cells, red blood cells, white cells, yeast cells and others. The urine color ranged from straw-colored, through amber to reddish-brown or coke-like, and cloudiness was evident in 42 of the urine samples. Blood, protein and red cells were seen in 10, 14 and 12 respectively of the subjects. The dipstick nitrite test, supported by microscopic examination showed 13 cases of bacteriuria. Twenty one subjects, 19 females and 2 males had yeast in the urine. In addition, 5 of them had ketone bodies, and there was one case of glucosuria. Overall, 117 (37.6% of sampled population) showed from one or more markers of possible urinary tract abnormality. Our results showed 36.1% of the subjects had markers of urinary tract disease, of which 15.3% could be, attributable to renal pelvis, sup- porting the fact that the sickling hemoglobinopathy is associated with various urinary tract abnormalities. The SS genotype had the higher frequency of occurrence of the markers, corroborating the inter-genotype differences in extent of nephropathy.