Hematological and Renal Function Parameters Between Patients With Sickle Cell Anemia and Individuals With Sickle Cell Trait
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction Sickle cell anemia (SCA) is characterized by homozygosity for hemoglobin S (HbS), chronic hemolysis, vaso-occlusion and multiorgan damage. Renal involvement resulting from these pathological changes is known as sickle cell nephropathy. In contrast, sickle cell trait (SCT), that occurs in heterozygous individuals for HbS, is commonly considered benign. However, emerging evidence suggests that SCT may present subclinical abnormalities, including renal involvement. Objectives To compare hematological parameters, hemolysis markers, complete blood count (CBC)-derived inflammatory indices and renal markers among individuals with SCA, SCT, and healthy controls. Material and Methods A cross-sectional observational study included 72 adults (55 with SCA, 6 with SCT, and 11 healthy controls) recruited from the Hematology Outpatient Clinic of the Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Niterói, RJ, and the university academic community. Assessments included CBC with reticulocyte count, hemolysis markers (lactate dehydrogenase (LDH), total and indirect bilirubin), renal function (serum creatinine and urea, estimated glomerular filtration rate (eGFR), urinary albumin- (uACR) and protein-to-creatinine ratio (uPCR), osmolarity and pH), and CBC-derived inflammatory indices (neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), neutrophil-to-platelet ratio (NPR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI)). Group comparisons were performed using one-way ANOVA or the Kruskal-Wallis test with appropriate post-hoc tests. A significance level of 5% was adopted. Results Red blood cell and hemolysis parameters were similar in SCT and the controls, but differed significantly in SCA (p<.01 for all). Both uACR and uPCR ratio were higher in SCA patients, with no differences between SCT and controls (p<0.0001 for both). Urinary osmolarity and pH were also similar between the SCT and control, differing from SCA (p<0.01 for both). Patients with SCA had higher eGFR than controls, whereas SCT individuals exhibited intermediate values that did not differ from either group (p=0.023). Among inflammatory indices, NPR was significantly higher in SCT and SCA compared controls (p=0.003). SIRI was significantly higher in SCA than in controls, while SCT individuals showed intermediate values without differences from either group (p<0.001). Discussion and Conclusion Our data suggest that, although the overall hematological profile of individuals with sickle cell trait is comparable to that of the healthy controls, subtle chances in inflammatory and renal function markers may reflect underlying subclinical processes. These findings challenge the traditional view of sickle cell trait as a clinically benign condition, particularly concerning renal function and inflammation. Longitudinal studies with larger cohorts are needed to confirm these associations.
Language: English
Subfield: Genetics (clinical)
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223094987