The renal features of sickle cell disease include some of the most common reasons for referral to nephrologists. This author, from the University of Kansas Medical Center, comprehensively reviews the renal effects of sickle cell disease, including hematuria, papillary necrosis, tubular disturbances and chronic glomerulopathy. All aspects of these complications are covered, including their presentation, pathogenesis, pathology, risk factors, diagnosis and treatment.