Dissertation (MMED Pediatric and Child Health)Sickle Cell Disease (SCD) is an established cause of progressive renal dysfunction which is increasingly associated with the development of end-stage renal disease. Identifying and preventing factors related to renal dysfunction in this population constitute a crucial strategy to halt the occurrence of this life-limiting complication. This study was conducted to determine factors associated with renal dysfunction among children with SCD. The referred were attended at two outpatient clinics in Dodoma, central Tanzania. This study aimed to determine the prevalence and factors associated with renal dysfunction among children with SCD aged one year to 18 years. This was a cross-sectional analytical study which was conducted from August 2020 to February 2021and involved 240 children with SCD aged 1 to 18 years. Demographic and clinical parameters were recorded using a structured questionnaire. Laboratory tests to evaluate renal dysfunction urine albumin and serum creatinine were conducted. Estimated glomerular filtration rate (eGFR) was calculated using the Schwartz formula. Renal dysfunction was defined as albuminuria of 30mg/g or eGFR of <60 ml/min/1.73m2. Statistical relationships were ascertained using chi-square test and multivariate analysis was conducted to determined predictors of renal dysfunction. Data analysis was performed using SPSS version 26 and statistical significance was assumed for factors with P < 0.05. Out of 240 children enrolled, 81 (33.8%) had renal dysfunction. Malnutrition (AOR=5.1, 95% CI [2.4 – 10.5], p <0.001), jaundice (AOR= 4.9, 95% CI [2 – 11.8], p <0.001) and leukocytosis (AOR=5.7, 95% CI [2 – 16.4], <0.001) were independently associated with renal dysfunction. High prevalence of renal dysfunction among children with SCD was observed in this study and factors which were associated with renal dysfunction included jaundice, malnutrition and leukocytosis on full blood picture. Urinary microalbuminuria is cheap, simple and quick test that can pick up the patients who may need further interventions during routine clinic visits, it can be done every after twelve month starting at age of one year.