Renal doppler-a screening tool of choice for sickle nephropathy

Background: Sickle cell anemia induces sickling of red cells due to polymerisation of sickle haemoglobin. Renal medulla is hypoxic and hypertonic and hence RBC are more prone to sickling. Some authors observed that changes in renal doppler indices {resistive index (RI), Pulsatility index (PI)} occur earlier than rise in biochemical parameters, hence this might be a better screening tool. Aims: correlation of renaldopplerindices in sickle cell anemia patients with biochemically normal, lower than normal and high renal function parameters. Methods: 108 Sickle cell patients between 6 month to 50 yrs, were subjected to Complete haemogram, renal function tests, ultrasonography of kidneys, followed by renal doppler study. Results were analyzed using SPSS software 23.Analysis Result: Of 108 patients,67.5% belonged to homozygous and 32.4% belonged to heterozygous group. Maximum patients belonged to an age group of 10-19 yrs and 1-9 yrs. RI and PI of the renal vessels were studied. Earliest changes were detected in interlobar artery. 43.6% patients of SS type and 27.2% of AS type had abnormal doppler changes. Increase in RI and PI was seen maximum in age group of 5-14 yrs (66 and 56% respectively) and 15-19 yrs. On comparission of renal indices with biochemical parameter, mean RI and PI were higher in children with low and high biochemical parameters as compared to children with normal biochemical parameters indicating more severe vascular changes. Conclusion: Study of renal indices in sickle cell patients is very useful in detecting early renal damage.