Renal Abnormalities in Patients with Sickle Cell Disease: A Single Center Report from Saudi Arabia

Patients with sickle cell disease (SCD) are at increased risk of serious morbidity and mortality. Renal abnormalities in SCD are well known but renal involvement in Saudi patients with SCD has not been studied. We sought to identify renal abnormalities in adolescent and adult Saudi patients with SCD. We prospectively studied 73 patients with SCD followed up at King Khalid University Hospital, Riyadh, Saudi Arabia from July 2005 to November 2006,. All patients underwent evaluation of kidney function and urine examination to detect proteinuria and other urinary abnormalities. In addition, 53 patients from the cohort had 24-hour urine collection to measure creatinine clearance and to quantitate proteinuria. The patient population consisted of 34 males (46.5%) and 39 females (53.5%) with a median age of 23 years (range 14-40). Proteinuria was present in 30 patients (41%). Creatinine clearance was low in 12 patients (22.5%) and seven of these patients had low or low-normal serum creatinine despite reduced creatinine clearance. Low serum creatinine was common and present in 28 patients (38%). Two patients had chronic renal failure and one of them is on regular dialysis. Other abnormalities detected include hematuria in seven patients (8.5%) and hemoglobinuria in 12 patients (14.5%). In conclusion, renal abnormalities are present in a significant number of Saudi patients with SCD and proteinuria is the most common abnormality. Serum creatinine may remain low or within low-normal range in SCD patients despite reduced creatinine clearance. As proteinuria is a risk factor for developing renal failure in future, routine screening of SCD patients is recommended for timely intervention in order to prevent or delay renal damage