Effect of renin-angiotensin-aldosterone system blocking agents on progression of glomerulopathy in sickle cell disease

Ashley Thrower, Emily J. Ciccone, Poulami Maitra, Vimal K. Derebail, Jianwen Cai, Kenneth Ataga

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)246-252
Number of pages7
JournalBritish Journal of Haematology
Volume184
Issue number2
DOIs
StatePublished - Jan 1 2019

Fingerprint

Sickle Cell Anemia
Renin-Angiotensin System
Proteinuria
Glomerular Filtration Rate
Albuminuria
Mortality
Retrospective Studies
Kidney
Therapeutics

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

Effect of renin-angiotensin-aldosterone system blocking agents on progression of glomerulopathy in sickle cell disease. / Thrower, Ashley; Ciccone, Emily J.; Maitra, Poulami; Derebail, Vimal K.; Cai, Jianwen; Ataga, Kenneth.

In: British Journal of Haematology, Vol. 184, No. 2, 01.01.2019, p. 246-252.

Research output: Contribution to journalArticle

Thrower, Ashley ; Ciccone, Emily J. ; Maitra, Poulami ; Derebail, Vimal K. ; Cai, Jianwen ; Ataga, Kenneth. / Effect of renin-angiotensin-aldosterone system blocking agents on progression of glomerulopathy in sickle cell disease. In: British Journal of Haematology. 2019 ; Vol. 184, No. 2. pp. 246-252.
@article{60bd67b8f1c344e1a3d65b287c64a187,
title = "Effect of renin-angiotensin-aldosterone system blocking agents on progression of glomerulopathy in sickle cell disease",
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.",
author = "Ashley Thrower and Ciccone, {Emily J.} and Poulami Maitra and Derebail, {Vimal K.} and Jianwen Cai and Kenneth Ataga",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/bjh.15651",
language = "English (US)",
volume = "184",
pages = "246--252",
journal = "British Journal of Haematology",
issn = "0007-1048",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Effect of renin-angiotensin-aldosterone system blocking agents on progression of glomerulopathy in sickle cell disease

AU - Thrower, Ashley

AU - Ciccone, Emily J.

AU - Maitra, Poulami

AU - Derebail, Vimal K.

AU - Cai, Jianwen

AU - Ataga, Kenneth

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85056750815&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056750815&partnerID=8YFLogxK

U2 - 10.1111/bjh.15651

DO - 10.1111/bjh.15651

M3 - Article

VL - 184

SP - 246

EP - 252

JO - British Journal of Haematology

JF - British Journal of Haematology

SN - 0007-1048

IS - 2

ER -