Hematological, liver and kidney parameters among Ghanaian steady state sickle cell disease patients

Background Sickle cell disease’s ( SCD) clinical hallmarks include hemolysis and vascular occlusive symptoms. In sickle cell disease (SCD), red blood cells are distorted into a sickle shape by the polymerization of deoxygenated hemoglobin S (HbS) molecules, which results in tissue destruction, hemolysis, and vaso-occlusion. Vaso-occlusion can result in organ damage, which may cause changes in blood cells, liver and renal function. This study investigated the complete blood count, liver and kidney profile of steady state sickle cell disease patients in Ghana. Methods This case-control study involved 64 SCD patients and 80 healthy subjects. Participants' information was thoroughly documented using a structured questionnaire and patient case records. Venous blood was drawn from each participant for the estimation of their hematobiochemical parameters. Findings: Majority of SCD patients were under 20 years of age (40.6%) compared to the non-SCD group (33.8%) ( p  = 0.062). Hemoglobin and hematocrit levels were significantly lower in HbSS participants (8.50 ± 1.45 g/dL and 24.50%, p  < 0.001 respectively) compared to HbSC (10.62 ± 1.76 g/dL and 30.35%, p  < 0.001) and non-SCD groups (11.73 ± 2.08 g/dL and 35.40%, p  < 0.001). Platelet, white blood cell (WBC), lymphocyte, and neutrophil counts were higher in HbSS participants, compared to HbSC ( p  < 0.001). Liver function markers showed significant increase in HbSS participants, with higher aspartate transaminase (AST) and alkaline phosphatase (ALP) levels (52.30 U/L, p  < 0.001 and 106.05 U/L, p  < 0.001 respectively) compared to HbSC and non-SCD groups. Fibrinogen and fibrinogen-to-albumin ratios (FAR) were higher in HbSS (4.59 g/L and 0.11, p  < 0.001 respectively). Moreso, there was high Urine Albumin-to-Creatinine ratio in HbSS 19.84 (6.77–34.97) compared to HbSC 18.44 (6.26–35.64) individuals. Neutrophil Gelatinase Associated Lipocalin (sNGAL) levels were significantly elevated in SCD, particularly HbSS (5.96 ng/mL, p  < 0.001), compared to non-SCD (4.35 ng/mL, p  < 0.001). Conclusion This study reported reduced levels of hemoglobin and hematocrit as well as high WBC and platelets among HbSS and HbSC patients compared to controls. We also observed normal liver function parameters in our patients and finally we reported normal levels of traditional renal markers but found high levels of NGAL in HbSS and HbSC patients compared to controls.