How is Sickle cell nephropathy diagnosed?
The diagnosis of SCN is based on clinical manifestations and is primarily a diagnosis of exclusion.
Routine evaluation for common causes of proteinuria (particularly when severe) and active urinary sediments, obstructive uropathy, and kidney biopsy should be performed as clinically indicated.
• Routine proteinuria evaluation for both infectious (e.g. HIV, hepatitis B and C) and noninfectious serologies associated with glomerular diseases based on age, gender, and risks.
• Imaging studies including kidney ultrasound to rule out obstructive uropathy, bladder scanning for postvoid retention or bladder neck obstruction, and possibly a computed tomography scan with or without contrast agent as clinically indicated.
• Review of recent or current use of nephrotoxic medications.
• Kidney biopsy as clinically indicated by active urinary sediment, significant proteinuria (e.g., urine protein to creatinine ratio >1 g/g) with predominant albuminuria, or unexplained rapid kidney function deterioration.