Sickle cell disease (SCD) patient are at risk of developing sickle nephropathy (SN). The aim of this study was to evaluate renal blood flow patterns and reno-vascular parameters in adult SCD patients without laboratory evidence of renal impairment.
Sixty-five steady-state adult patients with SCD (50 SS, 12 HbSβ0, and 3 SD), aged 32.89 ± 13.89 years and 30 age- and sex-matched healthy controls were studied. Kidney length, echo pattern, peak systolic velocity (PSV), end-diastolic velocity (EDV), renal-aortic ratio (RAR), resistive index (RI), acceleration time (AT), and renal vein velocity (RVV) were acquired, recorded, and analyzed using a curvilinear transducer of 1-5MHz through the abdomen.
The highest mean for ultrasound renal length and cortical thickness in the SCD and control groups were 11.78 ± 1.30cm and 11.27 ± 0.77cm, and 1.86 ± 0.41cm and 1.78 ± 0.28cm, respectively. The figures were significantly higher in the SCD patients group than the control group (P < 0.05). Sixty (90.8%) patients had a mild diffuse increase in cortical echogenicity with preserved renal cortical thickness. The highest mean extra-renal PSV in the SCD and control groups were 138.46 ± 56.32cm/s and 101.75 ± 31.48 cm/s, respectively (P < .05). However, the highest intra-renal RI and AT in SCD and control groups were 0.69 ± 0.07 and 0.06 ± 0.02s and 0.63 ± 0.05 and 0.04 ± 0.01s, respectively (P < .05). There was no significant correlation between RI and AT and PSV among the patients with SCD (P>.05).
Increased renal length and cortical echogenicity with elevated PSV and RI and AT values can serve as early sonographic changes in SCD adult patients without renal impairment.
Akram Asbeutah, Associate Professor/Dr, Kuwait University