0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Sickle Cell Nephropathy

Leonard B. Berman, MD
JAMA. 1974;228(10):1279. doi:10.1001/jama.1974.03230350051035.
Text Size: A A A
Published online

ABSTRACT

IT IS fitting that the shape of a sickled red blood cell (RBC) should resemble that of a kidney. The patient with sickle cell trait or disease is liable to experience several types of sickle cell nephropathy. The best known of these is gross hematuria, seen most often with the trait. The bleeding arises just beneath the pelvic mucosa, where masses of sharp-pointed sickled RBCs engorge and rupture venules. The low oxygen pressure and interstitial hypertonicity, which are characteristic of the renal medulla, undoubtedly favor the formation of these sickle cell masses.

The same concept applies to the second of the nephropathies, papillary necrosis. This is a slowly developing process affecting one papilla at a time and is not associated with acute renal failure. The third nephropathy is the nephrotic syndrome, associated with glomerular microinfarcts resulting from plugs of sickled RBCs. It is uncommon and unresponsive to steroid therapy. The

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();