One of the manifestations of early kidney disease in a patient with sickle cell disease is an increase in the glomerular filtration rate (GFR).
Pathogenesis: possibly increased renal blood flow mediated by prostaglandins and/or nitric oxide; possibly related to hemolysis
Criteria for hyperfiltration:
(1) eGFR > 130 mL per min per 1.73 square meters for females
(2) eGFR > 140 mL per min per 1.73 square meters for males
The maximum eGFR may be above 200 mL per min per 1.73 square meters.
Findings associated with hyperfiltration:
(1) young age
(2) absence of alpha thalassemia
(3) lower hemoglobin concentration, often associated with hemolysis
(4) lower fetal hemoglobin percentage
The GFR tends to decline with age.
Complications:
(1) micro or macro albuminuria which is indicative of glomerular injury
