Clinical studyEnalapril reduces the albuminuria of patients with sickle cell disease
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Considerations for the future: current and future treatment paradigms with mineralocorticoid receptor antagonists—unmet needs and underserved patient cohorts
2022, Kidney International SupplementsCitation Excerpt :The pivotal role for RAS inhibitors in retarding the progression of kidney disease is well established.18 Surprisingly, in light of the predominance of hyperfiltration, very few reports have been made of studies of patients with SCD-related nephropathy who were treated with RAS inhibitors.19,20 A 2015 Cochrane database review reported the potential for reduction in albuminuria and proteinuria with the use of captopril in patients with SCD, compared with those without the disease.21
Progression of albuminuria in patients with sickle cell anemia: A multicenter, longitudinal study
2020, Blood AdvancesCitation Excerpt :Our study provides new insight into the natural progression of albuminuria in SCA that is needed for the successful design of such studies. Our longitudinal study confirms previously reported findings and associations of sickle nephropathy.8,44,48-53 First, high baseline prevalence of albuminuria in a third of SCA patients was observed in our study.49-51,54
A Growing Population of Older Adults with Sickle Cell Disease
2019, Clinics in Geriatric MedicineCitation Excerpt :Acceleration of renal impairment should prompt investigation of common comorbidities, in particular, hypertension and diabetes.17 Observational data have shown that proteinuria responds to treatment with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and treatment with these agents should be considered when the urine protein/creatinine ratio is persistently elevated greater than 50 mg/mmol.49,50 Disease-modifying therapy (HU) should be considered alongside this specific treatment.48,51
Progressive Decline in Estimated GFR in Patients With Sickle Cell Disease: An Observational Cohort Study
2019, American Journal of Kidney DiseasesAmerican Society of Hematology 2019 guidelines for sickle cell disease: Cardiopulmonary and kidney disease
2019, Blood AdvancesCitation Excerpt :Urine albumin was reported in 1 RCT (n = 22)85 and 7 observational studies (total n = 114).86-92 In the 6 studies that examined ACEi therapy, 53 of 84 patients (63%) who received ACEi therapy showed improvement in urine albumin.86-88,90-92 Of those who improved while receiving ACEi therapy, 18 (34%) had severe albuminuria (macroalbuminuria), 6 (11%) had moderate albuminuria (microalbuminuria), and the rest did not have their degree of albuminuria specified.
How I treat the older adult with sickle cell disease
2018, BloodCitation Excerpt :Relevant to patient 1, observational data have shown that proteinuria responds to treatment with ACE inhibitors or angiotensin receptor blockers. Although there are no published guidelines on when to introduce ACE inhibitors or angiotensin receptor blockers, all adults should have urinary protein measurements performed at least annually and treatment with these agents should be considered when uPCR is persistently >50 mg/mmol.30,31 Disease-modifying therapy (HU) should be considered alongside this specific treatment.21,32