The pattern of renal artery Doppler indices in patients with sickle cell disease

Aim: To evaluate the pattern of renal artery Doppler indices in patients with sickle cell disease who do not have laboratory evidence of renal impairment. Material and methods: A case-control study was carried out after enrolling 50 patients with sickle cell disease (HbSS phenotype) (sickle cell disease group) and 50 con- trol subjects (control group). All the participants underwent ultrasound and color Doppler examination, and the pulsatility index and resistive index values of the main renal artery, segmental artery, and interlobar artery in both kidneys were recorded and compared. Results: The Doppler measurements of the main renal artery, segmental artery, and interlobar artery were compared between the control and sickle cell disease groups. It was found that both pulsatility index and resistive index were significantly higher in the sickle cell disease group, as compared to the control group, for the main renal artery, segmental artery, and interlobar artery (p <0.0001, p <0.0001, and p <0.0001, respectively). The optimal cut-off points for mean pulsatility index and resistive index, as measured by the Youden index, were found to be >1.08 (72% sensitivity and 88% specificity) and >0.635 (66% sensitivity and 98% specificity), respectively. Conclusions: Resistive index and pulsatility index values in renal Doppler sonography can serve as early radiologic predictors of renal vascular changes in sickle cell disease patients who do not have laboratory evidence of renal impairment.