Glomerular Lesions in Sickle Cell Nephropathy

Nine patients with sickle cell anemia (SS) and four with sickle cell trait (AS) were studied for evidence of nephropathy. Two of the SS patients died with uremia, and three others had proteinuria, including one with the nephrotic syndrome. With light microscopy, eight SS patients were found to have anatomical changes similar to those caused by a proliferative glomerulonephritis, whereas the AS patients were found to have no significant abnormalities. In cases of SS, renal function tests did not reflect the degree of pathological glomerular disease. Anatomical abnormalities seemed to correlate with the number of sickle cell crises, and may have been due to renal arteriolar ischemia. Previous reports of SS histology have not emphasized glomerular changes. It is postulated that, as the life span of SS patients increases, clinical evidence of glomerular disease will be seen more frequently.