Prevalence and associations of symptomatic renal papillary necrosis in sickle cell anemia patients in South-Eastern Nigeria

Abstract

The prevalence of symptomatic RPN is low in this group of homozygous S patients and occurs more commonly in females. Improvement in care for these patients will reduce these chronic complications.

Renal Papillary Necrosis Following Mesenteric Artery Stenting

“…Approximately 30% of all cases of RPN are likely due to patients with diabetes mellitus; however, the overall frequency and prevalence is unclear because of underdiagnosis of many asymptomatic cases [6]. Similarly, it is estimated that the incidence of RPN due to SCD is 30-40%, though this etiology may also be underdiagnosed [7]. Regardless, most cases of RPN result in painless microscopic hematuria; therefore, unless symptoms are severe enough to present clinically obvious hematuria or if the ischemic necrosis is large and breaks off into the ureters causing renal colic, these patients generally do not present with complaint to be further investigated.…”

Renal Papillary Necrosis as the First Presenting Clinical Feature in a Sickle Beta and Thalassemic Child

“…1,2 The incidence of renal complications in SCD has been estimated to be 68%, out of which 30 to 40% have RPN. 2,3,6 A study from Nigeria assessed 220 adult sickle cell patients and found only 2.3% of subjects having RPN. 3 A study in Saudi Arabia observed that 45% of patients with SCD had urological complications with 4% diagnosed with RPN.…”

“…2,3,6 A study from Nigeria assessed 220 adult sickle cell patients and found only 2.3% of subjects having RPN. 3 A study in Saudi Arabia observed that 45% of patients with SCD had urological complications with 4% diagnosed with RPN. 7 In a study at Mayo Clinic, 165 patients with RPN were evaluated and only 3% had SCD.…”

“…8 The spectrum of clinical features of RPN range from asymptomatic microscopic haematuria to acute pain, fever and even obstructive acute renal failure. 3,6 Hematuria occurs in 6% of children with SCD. 1,6 Common causes of hematuria and flank pain in SCD include RPN and urinary tract infections.…”

“…1,2 Renal injury in SCD, referred to as sickle cell nephropathy (SCN), is a frequent yet under-recognised complication. 2,3 Renal papillary necrosis (RPN) as the first presentation of SCD is rare. 4,5 We are reporting RPN as the first presenting clinical feature in a 12 year old Sickle Beta and Thalassemic child.…”