Renin-angiotensin system blockade promotes a cardio-renal protection in albuminuric homozygous sickle cell patients - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles (Data Paper) British Journal of Haematology Year : 2017

Renin-angiotensin system blockade promotes a cardio-renal protection in albuminuric homozygous sickle cell patients

Abstract

The management of sickle cell nephropathy (SCN) at an early stage is an important issue to prevent renal and cardiovascular morbidity and mortality. This study aimed to evaluate in this population, whether angiotensin converting enzyme inhibitors (ACEIs) treatment could exert a cardio-renal protection in a SCN cohort. Forty-two SCN patients (urine albumin:creatinine ratio (ACR) > 10 mg/mmol) were treated with ACEIs for 6 months, then evaluated for ACR, measured glomerular filtration rate (mGFR) together with haematological and cardiovascular parameters. A 1-month washout was also performed in order to differentiate short-and long-term ACEIs effects. A decrease in ACR baseline value (>30%) was detected in 62% of cases (mean ACR: 46Á4 AE 7Á6 and 26Á4 AE 3Á9 mg/mmol at baseline and 6 months respectively; P = 0Á002), whereas mGFR values were unchanged. ACR decrease was detected at 1 month following ACEI initiation (32Á9 AE 6Á9, P = 0Á02) with a persistent trend after withdrawal (P = 0Á08). ACEIs also decreased diastolic blood pressure (P = 0Á007), pulse wave velocity (P = 0Á01), tricuspid regurgitation velocity (TRV; P = 0Á04), asymmetric dimethyl arginine (ADMA: P = 0Á001) and haemoglobin (P = 0Á01) while conventional haemolytic biomarkers were unchanged. Our data suggest that ACEIs are safe and effective at decreasing albuminuria in sickle cell patients with a beneficial effect on specific mortality risk factors, such as TRV and asymmetric dimethyl arginine.
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inserm-04051866 , version 1 (30-03-2023)

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Jean-Philippe Haymann, Nadjib Hammoudi, Katia Stankovic Stojanovic, Frederic Galacteros, Anoosha Habibi, et al.. Renin-angiotensin system blockade promotes a cardio-renal protection in albuminuric homozygous sickle cell patients. British Journal of Haematology, 2017, 179 (5), pp.820-828. ⟨10.1111/bjh.14969⟩. ⟨inserm-04051866⟩
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