Acute renal failure in sickle-cell disease

Area of Science:

• Nephrology
• Hematology
• Toxicology

Background:

• Sickle-cell crisis is a common complication of sickle cell disease.
• Acute kidney injury (AKI) can occur during sickle-cell crisis.
• The causes of AKI in sickle-cell crisis are multifactorial.

Observation:

• Two patients presented with reversible acute oligoanuric renal failure during sickle-cell crisis.
• Renal failure was not due to volume depletion, obstruction, or nephrotoxins.
• Features suggested nontraumatic rhabdomyolysis in both cases.

Findings:

• Rhabdomyolysis, indicated by muscle breakdown, was suspected in patients with sickle-cell crisis and AKI.
• Pigmenturia, the presence of pigment in urine, may play a role in kidney damage.
• The renal failure observed was reversible, suggesting a treatable underlying cause.

Implications:

• Recognizing rhabdomyolysis and pigmenturia is crucial for managing AKI in sickle-cell crisis.
• Early diagnosis and intervention may prevent permanent kidney damage.
• Further research is needed to elucidate the precise mechanisms of pigmenturia-induced nephrotoxicity in sickle cell disease.