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Acute kidney injury in children with sickle cell disease-compounding a chronic problem

Cherry Mammen1,2, Mei Lin Bissonnette3, Douglas G Matsell4,5

  • 1Department of Pediatrics, University of British Columbia, Vancouver, Canada.

Pediatric Nephrology (Berlin, Germany)
|March 30, 2017
PubMed

Insights

Repeated acute kidney injury (AKI) in children with sickle cell disease (SCD) is an underreported issue. This can worsen chronic kidney disease and impact long-term kidney health.

Area of Science:

  • Pediatric Nephrology
  • Hematology
  • Genetics

Background:

  • Sickle cell disease (SCD) is a genetic blood disorder with significant renal manifestations.
  • Acute kidney injury (AKI) is a recognized complication in children with SCD.
  • Repeated AKI episodes pose a risk for progressive chronic kidney disease (CKD) in pediatric SCD patients.

Discussion:

  • Vaso-occlusive crises are a primary driver of AKI in SCD.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) used for pain management can exacerbate kidney injury.
  • The cumulative effect of repeated AKI on underlying CKD in children with SCD requires careful consideration.

Key Insights:

  • Underreporting of recurrent AKI in pediatric SCD is a critical clinical concern.
  • Long-term kidney outcomes are significantly threatened by repeated kidney insults.
  • Early recognition and management of AKI are crucial for preserving renal function.

Outlook:

  • Further research is needed to elucidate the mechanisms of AKI in pediatric SCD.
  • Development of nephroprotective strategies for children with SCD is essential.
  • Improved monitoring and management protocols for renal function in pediatric SCD patients are warranted.

Keywords:
Acute kidney injuryChildrenNon-steroidal anti-inflammatory drugsSickle cell nephropathyVaso-occlusive pain crisis

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