4 Interesting Facts of Sickle cell nephropathy
- 1. The clinical hallmarks of sickle cell disease are:
- • Hemolysis
- • Vasoocclusion
- • Ischemia reperfusion
The underlying mechanisms of kidney injury or sickle cell nephropathy (SCN) primarily relate to hypoxia and ischemia.
- 2. SCN encompasses a wide range of kidney abnormalities indicating that all segments of the nephron can be affected. The clinical presentation of SCN includes:
- • Hyposthenuria
- • Isothenuria
- • Hematuria
- • Proteinuria
- • Hyperkalemia
- • Papillary necrosis
- • Rental tubular acidosis
- • Nephrogenic diabetes insipidus
- • Glomerulonephritis
- • Acute kidney injury
- • Progressive decline in glomerular filtration rate and eventual development of end-stage kidney disease (ESKD)
- 3. Goal hemoglobin and correction rate of anemia should be no more than 10 to 10.5 g/dL and less than 1% to 2% per week, respectively. Higher hemoglobin levels and more rapid correction of anemia may precipitate a vasoocclusive crisis.
- 4. All forms of renal replacement may be beneficial to patients with ESKD from sickle cell anemia. These include hemodialysis, peritoneal dialysis, and kidney transplantation.
