Abstract
Background Nocturnal enuresis is a common symptom in children with
sickle cell disease (SCD). Risk factors for development of enuresis are
currently unknown. An early manifestation of SCD-associated kidney
damage is glomerular hyperfiltration. We test the hypothesis that in a
pediatric SCD cohort, individuals with hyperfiltration are more likely
to have nocturnal enuresis when compared to children without
hyperfiltration. Procedures To assess the relationship between nocturnal
enuresis and hyperfiltration, we retrospectively evaluated children with
SCD enrolled in the Evaluation of Nocturnal Enuresis and Barriers to
Treatment among Pediatric Patients with SCD study (PEESC; NCT01959958)
and prospectively identified children who reported nocturnal enuresis
and were enrolled in the longitudinal cohort study Sickle Cell Clinical
Research and Intervention Program (SCCRIP, NCT02098863). Results
Nocturnal enuresis occurred in 46.5% of PEESC participants and was more
frequent in participants with HbSS/HbSβ0-thalassemia and in male
participants. We did not identify an association between hyperfiltration
from three to five years of age with the later development of enuresis.
Hyposthenuria was not associated with enuresis. Conclusions Severe SCD
genotypes and male sex were associated with nocturnal enuresis after age
5 years. However, we could not identify additional renal or hematologic
predictors associated with the diagnosis of nocturnal enuresis. Future
studies should incorporate non-renal risk factors into studies that
predict development of enuresis.