Journal Article Observational Study Research Support, N.I.H., Extramural Ppublish 21 citations
PubMed: 30460977 DOI: 10.1111/bjh.15651
Effect of renin-angiotensin-aldosterone system blocking agents on progression of glomerulopathy in sickle cell disease.
Br J Haematol 184(2):246-252
Authors: Ashley Thrower, Emily J Ciccone, Poulami Maitra, Vimal K Derebail, Jianwen Cai, Kenneth I Ataga
Affiliations
- School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA.
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA.
- Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, NC, USA.
- Center for Sickle Cell Disease, University of Tennessee Health Science Center, Memphis, TN, USA.
Abstract
Although renin-angiotensin-aldosterone system (RAAS) blocking agents decrease albuminuria in short-term studies, there is no evidence confirming their long-term efficacy in sickle cell disease (SCD). In a single-centre, retrospective study, we evaluated the long-term effect of RAAS blocking agents on proteinuria and declining estimated glomerular filtration rates (eGFR). Eighty-six patients on RAAS blocking agents for proteinuria, followed for a median of 2·28 years, were compared with 68 patients with proteinuria followed for 2·24 years who were not receiving such treatment. The log odds of proteinuria decreased over time in patients on RAAS blocking agents (β: -0·23, P = 0·03) and in the non-treatment group (β: -0·54, P < 0·0001), but was not statistically different between both groups (β: 0·31, P = 0·063). The eGFR declined over time in patients on RAAS blocking agents (β: -2·78, P < 0·0001) and in those not on such treatment (β: -4·7, P < 0·0001), and was statistically different between both groups (β: 1·9, P = 0·0002). Baseline eGFR was associated with mortality (Hazard rato: 0·97, P < 0·0001), but RAAS blocking agents had no significant effect on mortality. These data suggest that RAAS blockade may slow the loss of kidney function in SCD.
MeSH
Cells, Proteinuria, Aldosterone, Mortality, Angiotensin-Converting Enzyme Inhibitors, Hematology, Anemia, Sickle Cell, Albuminuria, Renin, Angiotensins, Therapeutics
Cited by
- Rapid decline in estimated glomerular filtration rate in sickle cell anemia: results of a multicenter pooled analysis. Haematologica, 2021
- Longitudinal study of glomerular hyperfiltration in adults with sickle cell anemia: a multicenter pooled analysis. Blood Adv, 2022
- The nephropathy of sickle cell trait and sickle cell disease. Nat Rev Nephrol, 2022
- Levels of angiotensin-converting enzyme 1 and 2 in serum and urine of children with Sickle Cell Disease. J Bras Nefrol, 2021
- Reduced blood pressure in sickle cell disease is associated with decreased angiotensin converting enzyme (ACE) activity and is not modulated by ACE inhibition. PLoS One, 2022
- Rapid decline in estimated glomerular filtration rate is common in adults with sickle cell disease and associated with increased mortality. Br J Haematol, 2020
- Optimal disease management and health monitoring in adults with sickle cell disease. Hematology Am Soc Hematol Educ Program, 2020
- Olinciguat, a stimulator of soluble guanylyl cyclase, attenuates inflammation, vaso-occlusion and nephropathy in mouse models of sickle cell disease. Br J Pharmacol, 2021
- American Society of Hematology 2019 guidelines for sickle cell disease: cardiopulmonary and kidney disease. Blood Adv, 2020