Natural History of Chronic Kidney Disease in Sickle Cell Disease.

Kidney complications, referred to as nephropathy, develop early in sickle cell disease (SCD). In addition to its known morbidity, abundant data show that chronic kidney disease (CKD) is associated with an increased mortality risk in SCD. Increasing evidence suggests that the natural history of SCD nephropathy is progressive. Initial glomerular hyperfiltration without albuminuria appears to precede increasingly severe albuminuria, kidney function decline, and eventual kidney failure. Based on the current understanding of the natural history of SCD nephropathy, intervention before the development of overt kidney disease may prevent albuminuria and CKD progression and perhaps decrease mortality.