Albuminuria Reduction With Renin Angiotensin System Inhibitors in SCA Patients
Status:
Completed
Trial end date:
2014-09-01
Target enrollment:
Participant gender:
Summary
The prevalence of Sickle Cell Associated Nephropathy (SCAN) is increasing and is a growing
concern. Microalbuminuria is detected in the early onset of SCAN. Noteworthy, as in diabetic
nephropathy, hyperfiltration seems to be a frequent finding, with, in our series, an overall
incidence of 57 % and suggests a pathological links between glomerular hyperpressure and
glomerulosclerosis which occurs several years after. Nitric oxide (NO) deficiency and the
renin angiotensin system (RAS) are likely to be involved in the glomerular hyperpressure
leading to hyperfiltration. Renin angiotensin antagonists are currently given for
NEPHROPROTECTION in numerous nephropathy including SCAN despite few available reports. The
percentage of decrease of albuminuria or the percentage of responders (ie patient normalizing
albuminuria) has never been reported to our knowledge in SCAN patients at the time of
hyperfiltration. The focus of our study is therefore to 1) Quantify albuminuria reduction
after 6 months RAS treatment (primary end point); 2) Quantify glomerular filtration rate
(GFR) reduction after 6 months of RAS treatment, and to test the hypothesis of a beneficial
effect of RAS inhibitors on several biomarkers assessing hemolysis, NO inhibition and the
endothelial damages (secondary end points). The ultimate aim of our study is to identify
relevant (new) biomarkers associated to hyperfiltration and/or albuminuria decrease
(/normalization).