Pattern of Renal Blood Flow and Renovascular Parameters in Adult Patients With Sickle Cell Disease

Objectives: To evaluate renal blood flow patterns and renovascular parameters in adult patients with sickle cell disease (SCD) without laboratory evidence of renal impairment. Methods: Sixty-five steady-state adult patients with SCD (50 hemoglobin SS [HbSS], 12 HbSβ⁰, and 3 HbSD) and 30 age- and sex-matched healthy controls were studied. The kidney length, echo pattern, peak systolic velocity (PSV), end-diastolic velocity, renal-to-aortic ratio, resistive index (RI), acceleration time (AT), and renal vein velocity were acquired, recorded, and analyzed with a 1–5-MHz curvilinear transducer through the abdomen. Results: The mean age ± SD of the patients with SCD was 32.89 ± 13.89 years. The highest means for the ultrasound-measured renal length and cortical thickness in the SCD and control groups were 11.78 ± 1.30 and 11.27 ± 0.77 cm and 1.86 ± 0.41 and 1.78 ± 0.28 cm, respectively. The figures were significantly higher in the SCD group than the control group (P <.05). Fifty-nine (90.8%) patients had a mild diffuse increase in cortical echogenicity with preserved renal cortical thickness. The highest mean extrarenal PSVs in the SCD and control groups were 138.46 ± 56.32 and 101.75 ± 31.48 cm/s (P <.05). However, the highest intrarenal RI and AT in SCD and control groups were 0.69 ± 0.07 and 0.06 ± 0.02 seconds and 0.63 ± 0.05 and 0.04 ± 0.01 seconds (P <.05). There was no significant correlation between the RI, AT, and PSV among the patients with SCD (P >.05). Conclusions: Increased renal length and cortical echogenicity with elevated PSV, RI, and AT values can serve as early ultrasound changes in adult patients with SCD without renal impairment.