Hemoglobin

Hematuria in Sickle Cell Anemia

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Hematuria in Sickle Cell Anemia, Sickle Cell Nephropathy

  • See Also
  1. Sickle Cell Anemia
  2. Transient Red Cell Aplasia
  3. Acute Chest Syndrome
  4. Acute Vaso-Occlusive Episode in Sickle Cell Anemia
  5. Aplastic Crisis in Sickle Cell Anemia
  6. Cerebrovascular Accident in Sickle Cell Anemia
  7. Dactylitis in Sickle Cell Anemia (Hand Foot Syndrome in Sickle Cell Anemia)
  8. Osteomyelitis in Sickle Cell Anemia
  9. Priapism in Sickle Cell Anemia
  10. Pulmonary Hypertension in Sickle Cell Anemia
  11. Septic Arthritis in Sickle Cell Anemia
  12. Sickle Cell Anemia Related Pulmonary Hypertension
  13. Sickle Cell Anemia with Splenic Sequestration
  • Epidemiology
  1. Nephropathy occurs in 20% of SCA and is the most common complication of Sickle Cell Anemia
  2. Hematuria presents typically at age 20 to 30 years old
  3. Painless Gross Hematuria may also occur with Sickle Cell Trait
  • Pathophysiology
  1. Chronic RBC sickling results in renovascular Occlusion with secondary repeated ischemia and infarction
  2. Hematuria results from necrosis of tip of renal papillae and Medullary infarction
  • Findings
  1. Gross, Painless Hematuria
  2. Renal Colic pain and Costovertebral Angle Tenderness may occur
  3. Fever may occur
  • Diagnosis
  1. Rule out other causes of Gross Hematuria
  • Management
  1. Hematuria does not require hospitalization
  2. Aminocaproic Acid (EACA)
  • Course
  1. Gross, Painless Hematuria often continues for weeks
  2. Hematuria typically resolves spontaneously
  • Complications
  1. End Stage Renal Disease
    1. May progress from extensive and repeated vaso-Occlusion
  2. Urinary Tract Infection
    1. Higher risk for Cystitis or Pyelonephritis
  • References
  1. Dwyer, Kleinmann, Goswami and Lopez (2025) Crit Dec Emerg Med 39(1): 26-35