Renal abnormalities in sickle cell disease

Article Abstract:

Sickle cell anemia, an inherited, chronic disease, is characterized by a decrease in normal erythrocytes or red blood cells, and the presence of abnormal, sickle or crescent-shaped erythrocytes and abnormal hemoglobin, the oxygen-carrying pigment of the erythrocyte. Sickle cell anemia has been associated with abnormalities in the structure and function of the kidney. These include: the inability to concentrate urine; defects in ability to acidify urine and excrete potassium; and increased reabsorption of phosphate resulting in hyperphosphatemia, or increased blood levels of phosphate. In sickle cell anemia, an enhanced secretion of creatinine interferes with measuring the glomerular filtration rate (GFR), the speed at which the kidney glomeruli, consisting of capillary blood vessels, filter blood. Both GFR and blood flow in the kidney are increased in young patients with sickle cell disease, but GFR decreases with age in sickle cell patients. Deterioration of kidney function is caused by: proteinuria or the abnormal presence of protein in the urine; nephrotic syndrome, or disease of the capillary blood vessels within the glomerulus; and formation of fiber-like tissue in the glomeruli. Hemodialysis, or the artificial filtration of the blood, and kidney transplantation have been successful in treating sickle cell patients with advanced kidney failure. Recurrent hematuria, or blood in the urine, may be treated with aminocaproic acid. Papillary necrosis, the deterioration of the filtering portion of the kidney, may result from insufficient blood supply to the kidney tissue. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Sickle cell anemia

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Renal failure caused by chemicals, food, plants, animal venoms, and misuse of drugs

Article Abstract:

Nephrotoxins, or substances that are specifically toxic to the kidney, are an important cause of kidney failure. These substances may be classified into groups, including nephrotoxins that can be inhaled or absorbed through the skin and mucous membranes, ingested chemicals, foods and plants, animal venoms, and drugs given in excessive doses or misused by the patient. Inhaled or cutaneously absorbed nephrotoxins mainly consist of agents used in the workplace, but may also include agents inhaled to produce a euphoric state or to commit suicide, and preparations applied to the skin for medicinal or cleansing purposes. Kidney damage may also be caused by ingestion of: nephrotoxic chemicals, mainly industrial and agricultural substances; certain foods, such as milk, licorice, and rhubarb in large amounts or by an unusually sensitive individual; and nephrotoxic plants, such as castor beans, water hemlock, and toxic mushrooms, which may be ingested in the mistaken belief that they are edible. Stings by insects, such as spiders, bees, and wasps, and snake bites may introduce nephrotoxic venoms into the body and cause kidney damage. Some examples of nephrotoxins that are used for diagnostic or treatment purposes include contrast media used in X-ray techniques, nonsteroidal anti-inflammatory drugs, anticancer agents, and aminoglycoside antibiotics. The abuse of illegal drugs such as heroin have also been shown to cause kidney damage. The characteristics of kidney damage caused by these groups of substances are reviewed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Poisons, Kidneys, Kidney, Acute renal failure, Acute kidney failure, Insect venom, Wasp venoms

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