Angiotensin-converting Enzyme Inhibitors and Early Sickle Cell Renal Disease in Children
Status:
Terminated
Trial end date:
2012-06-01
Target enrollment:
Participant gender:
Summary
Patients with sickle cell anaemia may develop renal disease. In fact, renal disease occurred
in 40% of adults patients (macroalbuminuria) with evolution to end-stage renal disease for
half of them. Microalbuminuria is an early and sensitive marker of glomerular damage. It
appears during the first decade and occurred in 20 to 25% of infants (2 to 18 years).
Physiopathology of renal scarring is not well understood actually. Renal scarring might be
due to glomerular hyperfiltration and vascular and endothelial damage. Angiotensin-converting
enzyme inhibitors (ACE) were studied and used in diabetic nephropathy. In a study on 26
sickle cell adults, albuminuria was reduced about 50% by ACE compared to placebo after six
months treatment. It might be interesting studying ACE efficacy in sickle cell children with
microalbuminuria because renal disease is directly related to sickle cell and is not
influenced by other cardiovascular risk factors like in adult patients.
We hypothesized to have a successful ACE treatment in more than 40% of cases after a nine
months treatment period. A success is defined as a 50% reduction of the
albuminuria/creatinuria ratio.