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NDT Plus Advance Access originally published online on July 22, 2009
NDT Plus 2009 2(5):376-378; doi:10.1093/ndtplus/sfp081
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

An unusual cause of acute renal failure in sickle cell disease

Marie-Antoinette Rockx1, Ian W. Gibson2 and Martina Reslerova1

1 Department of Nephrology
2 Department of Pathology, University of Manitoba, Winnipeg, Manitoba, Canada

Correspondence: Correspondence and offprint requests to: Marie-Antoinette Rockx; E-mail: igibson{at}hsc.mb.ca


  Abstract

A young female with sickle cell disease was treated for biopsy-proven IgA nephropathy. Serum creatinine levels resolved to normal range, but a year later, she presented with oedema, hypertension and acute renal failure. A repeat renal biopsy showed acute-on-chronic thrombotic microangiopathy (TMA). We suggest that circulating microparticles could be a pathophysiological link between sickle cell disease and the development of renal TMA. This case emphasizes the importance of a further biopsy for acutely declining renal function, even when a definite diagnosis has been made from a previous biopsy.

Key Words: acute renal failure • renal pathology • sickle cell disease • thrombotic microangiopathy

Received for publication April 8, 2009. Accepted for publication June 16, 2009.


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