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Kidney dysfunction associated with sickle cell disease is most commonly due to sickling of red blood cells in the renal medulla because of low oxygen tension and hypertonicity. Congestion and stasis lead to hemorrhage, interstitial inflammation, and papillary infarcts with resultant necrosis. Clinically, hematuria is common. Damage to renal capillaries also leads to diminished concentrating ability. Isosthenuria (urine osmolality equal to that of serum) is routine, and patients can easily become dehydrated. These abnormalities are also encountered in patients with sickle cell trait. Sickle cell glomerulopathy is less common but will inexorably progress to ESRD. Its primary clinical manifestation is proteinuria. Optimal treatment requires adequate hydration and control of the sickle cell disease.

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Naik  RP  et al. Sickle cell trait and the risk of ESRD in blacks. J Am Soc Nephrol. 2017 Jul;28(7):2180–7.
[PubMed: 28280138]  
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Naik  RP  et al. The spectrum of sickle hemoglobin-related nephropathy: from sickle cell disease to sickle trait. Expert Rev Hematol. 2017 Dec;10(12):1087–94.
[PubMed: 29048948]  
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Nath  KA  et al. Sickle cell disease: renal manifestations and mechanisms. Nat Rev Nephrol. 2015 Mar;11(3):161–71.
[PubMed: 25668001]  

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