A Review of the Clinical Utility of Tubule-Specific Biomarkers in Sickle Cell Nephropathy.

Sickle cell nephropathy affects about 30%-50% of individuals living with sickle cell disease (SCD), raising the risk of mortality in this population. Traditional renal markers, such as serum creatinine and glomerular filtration rate, fail to detect renal damage until substantial injury occurs. However, growing evidence suggests tubular injury precedes glomerular damage, offering opportunities for earlier intervention through novel biomarkers that detect subclinical renal stress before albuminuria onset. In this narrative review, we evaluated kidney injury molecule-1, neutrophil gelatinase-associated lipocalin, N-acetyl-β-D-glucosaminidase, transforming growth factor-β, liver-type fatty acid binding protein, and monocyte chemoattractant protein-1 as early indicators of renal damage in individuals with SCD. Additionally, we examine the effect of existing SCD therapy on these biomarkers, highlighting their clinical relevance in sickle cell nephropathy.