There are some diseases that give rise to diverse renal manifestations as does sickle cell disease

Such involvement adversely affects virtually all major physiological processes in the kidney, and leads to complications that are common and chronic on the one hand (such as impaired urinary concentrating ability), and those that are rare and uniformly fatal on the other (such as renal medullary carcinoma) This steady adverse renal sequelae shortens the average lifespan of patients with SCD.

Proteinuria and a reduced glomerular filtration rate are risk factors associated with increased mortality among those patients with approximately 16-18% of overall mortality in this patient group is due to kidney disease.

Once end stage renal disease is reached, the mortality of patients who are on haemodialysis and have SCD is increased severalfold relative to the mortality of patients who are on haemodialysis but do not have SCD.

Thus,although the average lifespan of patients with SCD has increased during recent decades owing to improved management of complications outside the kidney,kidney disease contributes substantially to the still increased mortality in SCD.

Inclusion Criteria:

• All patients with sickle cell anemia attending the unit will be included in the study.

Exclusion Criteria:

• patient with any underlaying systemic diseases other than sickle cell anaemia

to assess degree of renal affection in patients with sickle cell disease attending Assuit university Children hospital by estimating some predictors of glomerular and tubular dysfunction.detailed history taking and thorough clinical examination and laboratory investigations