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Hyposthenuria and recurrent episodes of hematuria are well-known complications of the sicklecell disorders (1). Although it has been suggested that the defect in renal concentrating ability results from the presence of sickle hemoglobin within the circulating erythrocytes, there has been no satisfactory explanation for the special vulnerability of the kidney to the presence of such cells. A physiological characteristic differentiating the kidney from all other organs of the body is the high concentration of solutes normally attained in blood traversing the capillaries of the renal medulla (2, 3). It seemed worthwhile, therefore, to examine the effects of hypertonic solutions upon erythrocytes from patients with sickle-cell disease. The sickling phenomenon was found to be enhanced by concentrated solutions of sodium salts, and these results have suggested an explanation for the hyposthenuria associated with sickle-cell anemia.

SICKLING PHENOMENON PRODUCED BY HYPERTONIC SOLUTIONS: A POSSIBLE EXPLANATION FOR THE HYPOSTHENURIA OF SICKLEMIA*