Patients with sickle cell disease benefit enormously when members of the comprehensive care program are part of the management team. The chronic nature of sickle cell disease and the injury to various organ systems requires the coordinated care with other medical subspecialties. Standing relationships serve patients far better than ad hoc arrangements. Orthopedics Patients with sickle cell disease often suffer avascular necrosis of bone involving, most often, the hips and shoulders. This problem is extremely difficult to treat and requires close coordination with the orthopedic surgeons.
Some patients unfortunately come to replacement of joints, most often the hips.
An orthopedic surgeon who takes a special interest in the management of patients with sickle cell disease is ideal for this kind of program. Nephrology Patients with sickle cell disease suffer renal injury beginning early in life. Patients lose renal concentrating abilities by approximately the age of 18 months and are at higher risk of developing chronic renal failure. Close coordination with the nephrologist is an important issue. A patient with a serum creatinine of 2.0 in fact has substantially impaired renal function.