Introduction: Sickle cell disease is one of the most common genetic haemoglobinopathies. It is a major public health problem and kidney insufficiency is common among adult patients with the disease. The sickle haemoglobin leads to tissue hypoxia, causing acute tissue damage and chronic organ dysfunction including chronic kidney disease. Aim: To assess the prevalence and pattern of kidney disease among sickle cell patients in UMTH, Maiduguri, Borno State. Method: A hospital-based cross-sectional study conducted from January 2022 to June 2022 at the GOP and haematology clinics of the University of Maiduguri Teaching Hospital. Two hundred and forty (240) SCA participants receiving medical care at the outpatient sickle cell clinic were enrolled in the study. An equal number of age and sex-matched controls with Hb AA were also recruited. A structured questionnaire was administered to obtain demographic information, clinical history, blood pressure, and anthropometry. Blood and urine samples were taken for serumcreatinine and proteinuria determination respectively. The estimated GFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Data was analysed using International Business Machines-Statistical Package for Social Sciences (IBM-SPSS) version 21. P –value of < 0.05 was taken as significant. Results: Kidney disease was present in 44.6% of participants with SCA and present in 15% of the controls. The prevalence of hyperfiltration (GFR >120ml/min) and reduced GFR <60ml/min were also significantly higher in the SCA compared with controls 17.5% vs 1.7% and 38.3% vs 12% respectively. (p-value < 0.001). Serum creatinine levels correlated positively with albuminuria (r = 0.178; p = 0.006), while PCV correlated negatively with albuminuria (r = -0.178; p=0.006). The significant predictors of kidney dysfunction were the presence of albuminuria and high diastolic BP, with odd ratio (confidence interval) ...............