Renal Iron Load in Sickle Cell Anemia Patients - a Brazilian Study

Abstract Background and Objectives: Sickle cell anemia (SCA) is characterized by chronic haemolysis and frequent painful vaso-occlusive episodes, eventually leading to multiple organ damage, including the kidneys. Chronic haemolysis is frequent in SCA patients receiving regular transfusions. Not all renal disease in patients with SCA is due to sickle cell nephropathy (SCN), but the incidence of renal failure increases as patient survival improves. Since Magnetic Resonance Image can provide a unique evaluation of the abdomen in a single exam, the aim of this study was to assess renal iron deposits in patients with SCA, correlating these values with transfusion burden, liver and heart T2* and blood LDH levels. Material and methods: Twenty patients with SCA older than 20 years of age and transfusion burden were studied in a 1.5T scanner (Avanto, Siemens Medical Systems, Erlangen, Germany) using T2* technique and compared to age- and sex-matched normal controls. For liver T2* analysis, regions of interest (ROI) were manually drawn in the liver, using Viewing software (Leonardo - Siemens) avoiding all major visible vessels. For heart T2* analysis, a full-thickness ROI was manually defined in the interventricular septum (routinely chosen to avoid T2* artifacts from the cardiac veins, liver, and lungs). For renal T2* analysis, ROI were manually drawn in the cortex, using Viewing software (Leonardo - Siemens) avoiding the medullary region. All parameters are presented as mean ± standard deviation. Spearman’s rank test was used to assess the correlation between renal T2* and blood LDH levels. The Ethics Committee for Research approved this trial. Results: Mean renal T2* was significantly lower (p Disclosures No relevant conflicts of interest to declare.