Diagnosis of Renal Function and Structure for Sickle Cell Anemia in India during Vaso-occlusive Crisis (Voc)
Current Practice in Medical Science Vol. 6,
14 July 2022
,
Page 116-121
https://doi.org/10.9734/bpi/cpms/v6/15545D
Abstract
This present study reports severe renal derangement in four cases of Sickle cell Anemia during vaso-occlusive crisis. Paucity of reports from India regarding renal function derangement in sickle cell anemia cases during Vaso-occlusive crisis prompted us to report this present study. Sickle cell disease (SCD) is one of the commonest severe monogenic disorders in the world, due to the inheritance of two sickle haemoglobin genes from both parents.
All the cases had low Hemoglobin level and high reticulocyte and LDH level. Examination of urine revealed proteinuria, red cells in excess, hyposthenuria. High levels of serum urea ranging from 47 to 200mg/dl, Creatinine 0.58 to 6.2mg/dl and urea nitrogen 22 to 93mg/dl. The U.S abdomen mainly showed bilateral enlargement of kidney with acute renal parenchymal changes. Present study establishes the fact that in about 6.6% of homozygous sickle cell anemia cases there is gross derangement of renal function during VOC. In one of the cases, a kidney biopsy indicated Focal and Segmental Glomerulosclerosis (FSGS), as well as cellular and fibrocellular crescents. Sickle RBC were found in the capillary lumina. Twenty to thirty percent of the patients had interstitial fibrosis and tubular atrophy. As a result, renal dysfunction during a sickle cell crisis is widespread in India. However, because it is an emergency, one must be conscious of this fact and treat it proactively.
- Renal derangement
- renal function test
- sickle cell anemia
- vaso-occlusive crisis