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Urographic findings in homozygous sickle cell disease
Insights
This study found significant renal abnormalities in 69% of patients with sickle cell disease, with calyceal clubbing and papillary necrosis being common. These findings did not correlate with symptoms or hematological features.
Area of Science:
- Nephrology
- Hematology
- Radiology
Background:
- Sickle cell disease (SCD) is a genetic blood disorder with potential systemic complications.
- Renal involvement is a known complication of SCD, but its prevalence and specific manifestations require further elucidation.
Purpose of the Study:
- To prospectively evaluate renal abnormalities in patients with homozygous sickle cell disease using excretion urography.
- To investigate the correlation between urographic findings, clinical symptomatology, and hematological features.
Main Methods:
- A prospective study involving 189 patients with homozygous sickle cell disease.
- Excretion urography was performed to assess renal structure and function.
- Urographic findings were analyzed for prevalence and type of abnormalities.
Main Results:
- Renal abnormalities were detected in 69% of patients.
- Calyceal clubbing (39%) and papillary necrosis (23%) were the most common findings.
- No significant correlation was observed between urographic abnormalities and clinical symptoms or hematological parameters.
Conclusions:
- Homozygous sickle cell disease frequently leads to significant renal abnormalities detectable by excretion urography.
- Calyceal clubbing and papillary necrosis are prevalent, with increasing incidence of calyceal clubbing with age.
- Urographic findings in SCD appear independent of disease symptomatology and hematological markers.
Abstract:
A prospective study of the renal abnormalities on excretion urography in 189 patients with homozygous sickle cell disease is presented. Demonstrable abnormalities were present in 69% but there was no correlation with symptomatology. Calyceal clubbing was the most common abnormality occurring in 39% of cases and its incidence increased with age. An unexpectedly high prevalence (23%) of papillary necrosis occurred and both sinuses and cavities were demonstrated. The reasons for this high prevalence are discussed. The urographic findings did not correlate significantly with hematological features of the disease.