ASSESSMENTS OF RENAL FUNCTION PARAMETERS (CREATININE, UREA, AND EGFR) AMONG PEDIATRIC PATIENTS WITH SEVERE SICKLE CELL ANEMIA AT EL-DAMAZIN TEACHING HOSPITAL, BLUE NILE REGION, SUDAN (MARCH –OCTOBER, 2025)

Background: Sickle cell anemia (SCA) is a hereditary hemoglobinopathy characterized by chronic hemolysis, recurrent vaso-occlusive crises, and multi-organ dysfunction. It is particularly prevalent in sub-Saharan Africa, including Sudan, where the burden of sickle cell disease remains high due to consanguineous marriages and limited access to comprehensive healthcare. Among the various complications of SCA, renal dysfunction is a significant yet understudied concern, especially in pediatric populations. Despite the high burden of SCA in Sudan, particularly in Blue Nile Region, limited studies have assessed the renal function of pediatric SCA patients in this area. Objective: This study aimed to assess renal function among pediatric patients with severe SCA at Al-Damazin Teaching Hospital. Specifically, the study examines the prevalence of renal dysfunction, and their association with clinical and demographic factors in this population. Methods: A case-control, analytic, descriptive hospital based study, was conducted at El-Damazin teaching hospital, during March to August 2025. Pediatric patients aged 1-16 years diagnosed with sickle cell anemia was included. Renal function was assessed using, serum creatinine, serum urea, and estimation of glomerular filtration rate (eGFR). Data on demographics, sickle cell-related complication, and clinical parameter were collected and analyzed used statistical methods. Results: A total of 116 participants were enrolled in the study, comprising 66 children with severe sickle cell anemia (cases) and 50 healthy children (controls), all aged between 1 and 16 years. Regarding gender distribution, the SCA group comprised 37 males (56%) and 29 females (44%), while the control group included 26 males (54%) and 24 females (46%). A strong negative correlation was observed between GFR and both age (r = -0.788, p < 0.01) and weight (r = -0.727, p < 0.01), indicating that as children grow older and gain weight, their GFR tends to decrease. Additionally, a significant negative correlation was found between GFR and disease duration (r = -0.267, p < 0.05). In contrast, GFR was positively correlated with hemoglobin levels (r = 0.484, p < 0.01), suggesting that better hemoglobin status is associated with improved kidney function. Regarding serum urea, positive correlations were found with age (r = 0.716), weight (r = 0.684), and duration of illness (r = 0.299), all statistically significant, indicating that urea levels increase with these variables. Conversely, urea showed a significant negative correlation with hemoglobin levels (r = -0.361, p < 0.01), implying that lower hemoglobin is associated with higher urea levels. Serum creatinine also showed very strong positive correlations with age (r = 0.917) and weight (r = 0.974), both at p < 0.01, suggesting that creatinine levels increase significantly with age and body mass. Moreover, creatinine was positively correlated with disease duration (r = 0.348, p < 0.01) and negatively correlated with hemoglobin (r = -0.403, p < 0.01). Conclusion Sickle cell anemia is prevalent among pediatric in Sudan particularly n the Blue Nile Region. Earl detection and monitoring of the renal function are crucial for preventing long-term kidney damage and improving  the overall prognosis for these patients. The study highlights the need for regular screening and targeted interventions, as well as greater awareness of renal complications in SCA.