Figure 414

Relationship between age and ability to reverse the defect in urinary concentration by blood transfusions in patients with sickle cell disease. A, The maximal urinary osmolality achieved before transfusion (lower point of each vertical line) and after multiple transfusions with normal blood (upper point of each vertical line) in 14 patients with sickle cell disease, ranging in age from 2 to 40 years. B, The percentage of increase in maximal urinary osmolality resulting from transfusion. Maximal urinary osmolality before transfusion is depressed at all ages; significant improvement after transfusion occurs only in children and adolescents. (From van Eps et al. [13]; with permission.)

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