title: Proteinuria in adults with sickle-cell disease: the role of hydroxycarbamide(hydroxyurea) as a protective agent.
abstract: BACKGROUND
  Renal abnormalities are often seen in sickle cell disease (SCD).
  
  
  OBJECTIVE
  To investigate the role of hydroxycarbamide as a protective agent in sickle cell nephropathy.
  
  
  METHODS
  Patients with SCD followed at a Hematology outpatients clinic.
  
  
  METHODS
  Prospective study with 26 SCD patients. Renal function evaluation was performed and a comparison between patients and control group was done. Patients using hydroxycarbamide were compared to those not taking this drug.
  
  
  METHODS
  Effect of hydroxycarbamide on renal function.
  
  
  RESULTS
  Patients mean age was 32.1 ± 9.9 years, and 16 (61 %) were males. Glomerular hyperfiltration was found in nine patients with SCD (34.6 %). GFR < 60 mL/min/1.73 m² was observed in three cases (11.5 %). Microalbuminuria (30-300 mg/day) was found in seven cases (27 %) and macroalbuminuria (>300 mg/dia) in one patient (3.8 %). All patients had urinary concentrating deficit, and inability to acidify urine was found in ten cases (38.4 %). The comparison of patients according to the use of hydroxycarbamide showed lower levels of serum creatinine in those using the drug (0.6 ± 0.1 vs. 0.8 ± 0.3 mg/dL, p = 0.03), as well as lower levels of 24 h-proteinuria (226 ± 16 vs. 414 ± 76 mg/dL, p = 0.0001), but not microalbuminuria (79 ± 15 vs. 55 ± 86 mg/dL, p = 0.35).
  
  
  CONCLUSIONS
  SCD is associated with important renal abnormalities. Hydroxycarbamide seems to protect kidney function in SCD by decreasing proteinuria but not microalbuminuria.
authors.affiliation: Department of Internal Medicine, School of Medicine, Federal University of Ceará, Rua Vicente Linhares, 1198, Fortaleza, Ceará, CEP 60135-270, Brazil, geraldobezerrajr@yahoo.com.br.
authors.forename: Geraldo B
authors.initials: GB
authors.lastname: Silva Junior
authors.forename: Ana Patrícia F
authors.initials: AP
authors.lastname: Vieira
authors.forename: Amanda X
authors.initials: AX
authors.lastname: Couto Bem
authors.forename: Marília P
authors.initials: MP
authors.lastname: Alves
authors.forename: Gdayllon C
authors.initials: GC
authors.lastname: Meneses
authors.forename: Alice M C
authors.initials: AM
authors.lastname: Martins
authors.forename: Sonia M H A
authors.initials: SM
authors.lastname: Araújo
authors.forename: Alexandre V
authors.initials: AV
authors.lastname: Libório
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Daher
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D000986:Antisickling Agents / Q000627:therapeutic use*; D001938:Brazil; D015331:Cohort Studies; D005260:Female; D060730:Glomerular Filtration Barrier / Q000187:drug effects / Q000503:physiopathology; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006785:Hospitals, University; D006801:Humans; D006863:Hydrogen-Ion Concentration; D006918:Hydroxyurea / Q000627:therapeutic use*; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D007671:Kidney Concentrating Ability / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D011507:Proteinuria / Q000209:etiology / Q000517:prevention & control*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000986:Antisickling Agents; D006918:Hydroxyurea