Renal papillary necrosis in a patient with sickle cell trait

A patient with sickle cell trait who presented with gross hematuria and was subsequently found to have renal papillary necrosis is presented. The hematuria resolved with conservative therapy consisting of bed rest and hydration with hypotonic intravenous fluids. The pathophysiology of renal abnormalities associated with sickle cell trait is described. The management of the primary clinical manifestations of this disorder, hematuria and papillary necrosis, are discussed.