Risk Factors of Powars et al for Chronic Renal Failure in Sickle Cell Disease

Patient selection: sickle cell disease

Exclusion: diabetes, SLE or other causes of chronic renal failure

Risk factors for chronic renal failure:

(1) ineffective erythropoiesis with progressive anemia (steady-state decreasing hemoglobin concentration of more than 20 g/L with decreasing reticulocyte count or increased severity of anemia at a hemoglobin level of 50 g/L requiring supportive transfusions)

(2) hypertension

(3) proteinuria including nephrotic syndrome

(4) microscopic hematuria

Histopathologic correlates:

(1) glomerulosclerosis

(2) glomerular drop out

The findings can be most striking in young adult.