Nephrology nurse decries rise in complications of sickle cell disease in Nigeria, proffer solutions

To commensurate the World Sickle Cell Diseases Day (SCD), Margaret, a registered and practising nephrology nurse has decried the complications of sickle cell disease (SCD) also known as ‘Sickle Cell Nephropathy’.

Margaret, yesterday, took to her YouTube channel ‘Margaretlovenursing’ to educate the public about the complications of the disease.

Her words: “Sickle cell nephropathy is a spectrum of changes that results from the cascade of events occurring in the kidney. Sickling of the red blood cells and blockage of smaller vessels triggers this.

“The sickling of red blood cells in SCD makes the kidney one of the major organs affected because it has numerous tiny blood vessels. Some of the symptoms could be silent but it all becomes pronounced as the disease advances. One of the earliest symptoms of SCD nephropathy is hyposthenuria, blood in the urine, protein in the urine, high blood pressure amongst others.”

Giving the symptoms of sickle cell nephropathy, Margaret explained that hyposthenuria is a condition where there is reduced concentration of solutes in the urine with low specific gravity and this predisposes the charge to dehydration.

“This dehydration if not adequately handled immediately can amplify the disease process and cause Acute Kidney Disease; hence patients are advised to take lots of water,” she noted.

Margaret added: “Hyposthenuria is believed to occur from the age of seven but they are mostly presented at the hospital from the age of 10 to 15. Blood in the urine as one of the symptoms of SCD Nephropathy can be very painful and it’s as a result of trapped necrotic tissues of the kidney blocked in urine connecting system.

“Proteinuria is also one of the symptoms and we all know fhat the major work of the kidney is to filter blood with the help of the glomerulus, which is like a sieve, that filter out toxic compounds from the body, while retaining the good ones. Proteins are one of the things retained by this mechanism. Proteinuria can make this sieve become porous, thereby letting protein leak into the urine and this contributes greatly to the kidney destruction as it happens continuously. A raised blood pressure could be a marker of kidney involvement and such a patient should be watched closely and this can be managed with blood pressure control and proper hydration.”

She stressed that to have a child diagnose with sickle cell can be very challenging and scary especially for the parents. However, with treatments and prevention of complications, most patients live up to 40 to 50 years. This means that diagnosing a child with sickle cell disease does not mean death is around the corner because with proper treatments and prevention, their quality of life can be better.

She explained that it is essential to catch up or be in line with the specialists handling the patient so that the disease can be diagnosed in time and screening done for complications followed by prompt and correct treatment.

Margaret therefore advised that prevention and control of protein spillage in the kidney is very important, as it is the main way of managing SCD nephropathy.