Six Months of Hydroxyurea Reduces Albuminuria in Patients with Sickle Cell Disease

被引：73

作者：

Bartolucci, Pablo ^{[1
,2
,7
,8
,10
]}

Habibi, Anoosha ^{[1
,2
,7
]}

Stehle, Thomas ^{[3
,7
]}

Di Liberto, Gaetana ^{[7
,8
,10
]}

Rakotoson, Marie Georgine ^{[7
,8
,10
]}

Gellen-Dautremer, Justine ^{[1
,2
,7
]}

Loric, Sylvain ^{[4
,7
]}

Moutereau, Stephane ^{[4
,7
]}

Sahali, Dil ^{[3
,7
,9
]}

Wagner-Ballon, Orianne ^{[5
,7
]}

Remy, Philippe ^{[3
,7
,9
]}

Lang, Philippe ^{[3
,7
,9
]}

Grimbert, Philippe ^{[3
,7
,9
]}

Audureau, Etienne ^{[6
,7
]}

Godeau, Bertrand ^{[2
,7
]}

Galacteros, Frederic ^{[1
,2
,7
,8
,10
]}

Audard, Vincent ^{[3
,7
,9
]}

机构：

[1] Univ Paris Est Creteil, Sickle Cell Referral Ctr, Creteil, France

[2] Univ Paris Est Creteil, Dept Internal Med, Creteil, France

[3] Univ Paris Est Creteil, Dept Nephrol & Renal Transplantat, Creteil, France

[4] Univ Paris Est Creteil, Dept Biochim Pharmacotoxicol, Creteil, France

[5] Univ Paris Est Creteil, Dept Hematol & Immunol Biol, Creteil, France

[6] Univ Paris Est Creteil, Publ Hlth Unit, EA Equipe Accueil CEpiA Clin Epidemiol & Ageing U, Creteil, France

[7] Univ Paris Est Creteil, Grp Hosp Henri Mondor Albert Chenevier, AP HP, Creteil, France

[8] Univ Paris Est Creteil, Unite Inst Natl Sante & Rech Med INSERM, U955, Equipe 2, Creteil, France

[9] Univ Paris Est Creteil, Unite INSERM, U955, Equipe 21,Idiopath Nephrot Syndrome Referral Ctr, Creteil, France

[10] Lab Excellence Globule Rouge Excellence GR Ex, Paris, France

来源：

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2016年 / 27卷 / 06期

关键词：

CHRONIC KIDNEY-DISEASE; GLOMERULAR HYPERFILTRATION; ADULT PATIENTS; ANEMIA; HEMOLYSIS; NEPHROPATHY; PREVALENCE; PROGRESSION; CHILDREN; MICROALBUMINURIA;

D O I：

10.1681/ASN.2014111126

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

The earliest symptom of glomerular injury in patients with sickle cell disease (SCD) is microalbuminuria. The effect of hydroxyurea (HU) on urine albumin-to-creatinine ratio (ACR) is unclear and should be determined, because increasing numbers of patients with SCD take this drug to improve red blood cell function. In this cohort study of 58 SS-homozygous adults with SCD who initiated HU therapy, we evaluated ACR changes and relationships of these changes with demographic, clinical, and biologic parameters at HU initiation (baseline) and 6 months later (follow-up). Between baseline and follow-up, ACR declined significantly for the entire population (3.0-1.7 mg/mmol; P<0.01), but this was primarily driven by the ACR reduction in the microalbuminuria subgroup (8.1-2.3 mg/mmol; P=0.03; n=23). According to bivariate analyses on 39 patients who did not receive a blood transfusion during the study period, the baseline to follow-up ACR decline was strongly associated with decreases in levels of hemolysis markers, percentage of dense red blood cells, and systolic BP. Bivariate analysis also revealed a close association between the ACR decrease and high baseline levels of hemolysis markers and percentage of dense red blood cells. These results show that urine ACR decreased significantly after 6 months of HU and confirm a close relationship between ACR and hemolysis evolution in patients with SCD.

引用

页码：1847 / 1853

页数：7

共 40 条

[1] Short-term follow-up of patients with sickle cell disease and albuminuria [J].