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Is renal medullary carcinoma the seventh nephropathy in sickle cell disease? A multi-center Nigerian survey

Anazoeze Madu, Najibah Galadincci, Garba Umar, Shehu Abdulahi, Florence Fowodu, Abdulaziz Hassan, Marcus Inyama, Oluwaseun Akinpelu, Theresa Nwagha, Obike Ibegbulam, Sunday Ocheni, Ifeoma Emodi, Anthony Ikefuna, Barth Chukwu, Chide Okocha, Joseph Orkuma, Malachy Iheanacho, Kaladada Korubo, Uche Anike, Kingsley Agu, Charles Nonyelu, Angela Ugwu, Augustin Duru, Chikwudi Anigbo, Alozie Eze, Uchenna Ololo, Caroline Omoti, Obineche Agwu, Iheanyi Okpala

Abstract


Introduction: Previous studies had enlisted renal medullary carcinoma (RMC) as the seventh nephropathy in sickle cell disease (SCD). Clinical experience has contradicted this claim and this study is targeted at refuting or supporting this assumption.

Objective: To estimate the prevalence of RMC and describe other renal complications in SCD.

Materials and methods: 14 physicians (haematologists and urologists) in 11 tertiary institutions across the country were collated from patients’ case notes and hospital SCD registers.

Results: Of the 3,596 registered sickle patients, 2 (0.056%) had been diagnosed with RMC over a ten year period, thereby giving an estimated prevalence rate of 5.6 per 100,000. The most common renal complication reported by the attending physicians was chronic kidney disease (CKD). The frequency of routine renal screening for SCD patients varied widely between centres – most were done at diagnosis, annually or bi-annually.

Conclusion: The ten year prevalence of RMC in Nigerian SCD patients was determined to be 5.6 (estimated incidence of 0.56). RMC is not more common in SCD patients and therefore cannot be regarded as a “Seventh Sickle nephropathy”. Most of the managing physicians reported that the commonest nephropathy observed in their SCD patients was chronic kidney disease.

Keywords: Renal medullary carcinoma, seventh nephropathy, sickle cell disease, Nigerian survey




http://dx.doi.org/10.4314/ahs.v16i2.17
AJOL African Journals Online