الفهرس 
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Abstract
Sickle cell anemia is one of the most common inherited hemoglobin disorders a single gene disorder which is produced by a point mutation in the beta globin gene which is found on chromosome 11. This leads to have HbS instead of HbA. On exposure to hypoxic conditions, the absence of a polar amino acid at position six of the β-globin chain encourages the non-covalent polymerization (aggregation) of hemoglobin, which changes the shape and elasticity of RBCs. these distorted RBCs cannot pass through narrow capillaries, leading to occlusion of blood vessels. SCD can affect the kidneys through multiple pathways that known as sickle cell nephropathy (SCN), typically presents during childhood. The aim of the study is to assess urinary level of IL-18 and assess its value as early marker of renal involvement. The study was conducted on 86 children divided into two groups: group 1: included 50 pediatric cases of sickle anemia ( 25 patients homozygous sickle anemia (HbSS) & 25 patients with sickle thalassemia (HbSβ)) who were already diagnosed and follow up at pediatric hematology clinic at Beni-suef university Hospital and group 2: included 36, age and gender matched healthy children, as a control group. Ther was no significant difference between the cases and controls regarding their age, sex, and family history of renal disease. The main findings of the study were that: The family history of SCA was significantly higher in cases with SCA (P value 0.001) Level of urinary IL18 was significantly higher in cases with SCA than controls, with mean values of (140.5±43.6) & (97.6±23.5) respectively with (P value of <0.001). albumin/creatinine ratio were significantly correlated positively with the IL18 level with p value of (<0.001). The mean value of in patients with normoalbumiuria was (127.667) and those with microaluminuria was (132.59) and those with macroalbuminuria was (173.45) There was a significant higher IL18 level in SCA patients with Macroalbuminuria with p value of (0.024) There was a significant lower IL18 level in patients with Sickle/Thalassemia than Sickle only with p value of (0.032). There was a significant higher of IL18 (as an indicator of renal affection) level in cases with not treated with hydroxyurea.