title: Prevalence and associations of symptomatic renal papillary necrosis in sickle cell anemia patients in South-Eastern Nigeria.
abstract: OBJECTIVE
  To assess the prevalence and associations of symptomatic renal papillary necrosis (RPN) in sickle cell anemia patients.
  
  
  METHODS
  The case notes of homozygous hemoglobin (Hb) S patients diagnosed with RPN were retrospectively assessed. Diagnosis was based on microscopic hematuria and positive ultrasound findings. Their steady state diastolic blood pressure, Hb, leukocyte count, platelet count, serum direct bilirubin, and aspartate transaminase, were obtained by automated analyzers. These were evaluated for any relationship with the occurrence of RPN.
  
  
  RESULTS
  Two hundred and twenty patients were assessed aged 6-55 years with a median age of 24 years. The prevalence of symptomatic RPN was found to be 2.3%. RPN was positively associated with the female gender (Chi-square P value 0.001), but not with any other clinical or laboratory variable. However, other predictors of disease severity were positively associated with RPN such as age, diastolic blood pressure 0.180 (P = 0.016), serum aspartate transaminase, serum bilirubin 0.145 (0.027), Hb, and leukocyte count - 0.155 (P = 0.003).
  
  
  CONCLUSIONS
  The prevalence of symptomatic RPN is low in this group of homozygous S patients and occurs more commonly in females. Improvement in care for these patients will reduce these chronic complications.
authors.affiliation: Department of Haematology and Immunology, University of Nigeria, Enugu Campus, Enugu, Nigeria.
authors.forename: A J
authors.initials: AJ
authors.lastname: Madu
authors.affiliation: Department of Haematology and Immunology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
authors.forename: A E
authors.initials: AE
authors.lastname: Okoye
authors.affiliation: Department of Haematology and Immunology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
authors.forename: I C
authors.initials: IC
authors.lastname: Ajuba
authors.affiliation: Department of Orthopaedics, National Orthopaedic Hospital, Enugu, Nigeria.
authors.forename: K A
authors.initials: KA
authors.lastname: Madu
authors.affiliation: Department of Haematology and Immunology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
authors.forename: C
authors.initials: C
authors.lastname: Anigbo
authors.affiliation: Department of Haematology and Immunology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
authors.forename: K
authors.initials: K
authors.lastname: Agu
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D007681:Kidney Papillary Necrosis / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D055815:Young Adult