Full Text Article. Also available at: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0218024&type=printableBackground: Little is known on how the interaction between Sickle Cell Disease (SCD) and renal insults caused by other coexisting conditions in Sub-Saharan Africa such as urinary schistosomiasis, malnutrition and HIV affect the prevalence of Renaldas function in children with SCD.ObjectivesTodeterminetheprevalenceandfactorsassociatedwithrenaldysfunctionamongchil-drenwithSCDaged6 months to 12yearsattendedat a tertiary hospital in Northwestern Tanzania. Methods: A cross sectional hospital-based study with a short follow up component of 3 months for153 children with SCD was done to document demographics, clinical characteristics and features of Renaldas function including urine dipstick albuminuria (>20mg/l) and eGFR (<60ml/ml/min/1.73m2). Other potential renal insults such as HIV infection and Schistosomiasis were also evaluated. Results At enrollment, 48/153(31.37%) children had renal dysfunction declining to 31(20.3%) at 3 months follow up. Acute chest syndrome (OR3.04,95%CI[1.08–8.96],p = 0.044), severe anemia (OR0.44,95%CI[0.26–0.76], p= 0.003), urinary schistosomiasis (OR7.43,95%CI[2.10–26.32]p<0.002) and acute malnutrition (OR4.92,95%CI[1.29–18.84],p = 0.020). Were associated with renal dysfunction. Conclusion: Where prevalent, urinary schistosomiasis and acute malnutrition increase the risk for renal dysfunction in children with SCD. Were commend albuminuria routine screening in children with SCD especially those presenting with acute chest syndrome, severe anemia and features of acute malnutrition for early detection of renal dysfunction among children with SCD.