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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


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eISSN: 1729-0503
print ISSN: 1680-6905