Study of Kidneys in Patients with Sickle Cell Disease using Ultrasonography

Abstract

The aim of this study was to evaluate the impact of sickle cell disease (SCD) on kidneys by using ultrasonography. The method adapted was an experimental study among a sample consists of 115 SCD patients and 100 as control group with different gender and age group were selected. The study was carried out in west of Sudan where SCD has been an endemic disease among the community, from the period of August 2014 to March 2017. Right and left kidneys volume and echogenicity were assessed as well as right & left renal arteries resistive and pulsatilty indices were measured. The results analysis carried out by EXCELL software for the collected variables which revealed that, the incidence of SCD among the selected sample was (54.6%) for male and the female represents (45.4%) with mean age of 10.5±4/years for SCD patients and 17±4.9/years for control group and their body mass index (kg/m2) 16.8±3 & 23.2±5.5 for the patients and control group respectively. The right and left kidney volumes (cm3) were 59.41±2.21 and 98.38±21.38/ cm3 as atrophied relative to control group. The resistive and pulsatilty indices for the right and left renal arteries of patients were (0.8±0.2/1.5±0.4) and (0.77±0.1/1.6±0.2) respectively, which were greater than in control group (0.7±0.1 & 1.4±0.4) and (0.7±0.1 & 1.5±0.5), and as well the SCD used to increase the echogenicity of the kidneys. The study also revealed that; there is a direct proportional linear relationship between RI and BMI for the right renal artery in patients and control group; with prominent increment (0.011 kg/m2) for patient RI relative to control group (0.004kg/m2). Similarly to PI versus BMI, where it increased by a factor of (0.053kg/m2) compared with control group (0.016kg/m2). For the left renal artery; the RI has direct proportional linear relationship with BMI, as it increases by a factor of (0.018/kg/m2) compared with the control groups which were (0.004/kg/m2). Similarly the PI has direct proportional v relationship with BMI, where it increases by a factor of (0.050/kg/m2) relative to control group which were (0.018/kg/m2). Since the sickle cell disease has an impact in kidneys, the worth outcome of this study proved that: Kidneys ultrasonography as kidneys volume, echogenicity and renal artery RIs & PIs could be used successfully as early sonographic predictors of kidneys changes for SCD and/or other diseases which could have same or similar impact in the kidneys at early stage. After successful finishing of this study we recommend for further studies in the same region, encouraging the population for marriage from non relative ones, establishing more specialized centers with modern equipments and community education about the morbidities of the sickle cell disease.