Introduction: Sickle cell nephropathy involves both glomerular and tubular abnormalities that begin early in childhood. This study aimed to describe the profile of renal involvement in children with homozygous SS sickle cell anemia followed in Mbujimayi.

Methods: A comparative cross-sectional study was conducted among 71 children with homozygous SS sickle cell anemia and 71 HbAA controls. The renal abnormalities investigated included microalbuminuria, proteinuria, and urinary density abnormalities.

Results: The overall prevalence of renal involvement was 90,1% in sickle cell children compared to 54.9% in the control group. Microalbuminuria was the most frequent abnormality (67,6%), followed by proteinuria (21,1%). Sickle cell children had significantly lower hemoglobin levels (7,43 ± 1,70g/dL vs 12,50 ± 0,79 g/dL; p < 0.001). Patients with proteinuria were predominantly aged 9 to 10 years and had a BMI < 14 kg/m².

Conclusion: Renal involvement is frequent and occurs early in sickle cell children in Mbujimayi. Microalbuminuria remains the primary marker for early screening