title: Six Months of Hydroxyurea Reduces Albuminuria in Patients with Sickle Cell Disease.
abstract: 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.
authors.affiliation: Sickle Cell Referral Center, Department of Internal Medicine, Unité Institut National de la Santé Et de la Recherche Médicale (INSERM) U955, Equipe 2 and Laboratory of Excellence Globule Rouge Excellence (GR-Ex), Paris, France Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France; pablo.bartolucci@aphp.fr vincent.audard@aphp.fr.
authors.forename: Pablo
authors.initials: P
authors.lastname: Bartolucci
authors.affiliation: Sickle Cell Referral Center, Department of Internal Medicine, Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France;
authors.forename: Anoosha
authors.initials: A
authors.lastname: Habibi
authors.affiliation: Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France; Department of Nephrology and Renal Transplantation.
authors.forename: Thomas
authors.initials: T
authors.lastname: Stehlé
authors.affiliation: Unité Institut National de la Santé Et de la Recherche Médicale (INSERM) U955, Equipe 2 and Laboratory of Excellence Globule Rouge Excellence (GR-Ex), Paris, France Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France;
authors.forename: Gaetana
authors.initials: G
authors.lastname: Di Liberto
authors.affiliation: Unité Institut National de la Santé Et de la Recherche Médicale (INSERM) U955, Equipe 2 and Laboratory of Excellence Globule Rouge Excellence (GR-Ex), Paris, France Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France;
authors.forename: Marie Georgine
authors.initials: MG
authors.lastname: Rakotoson
authors.affiliation: Sickle Cell Referral Center, Department of Internal Medicine, Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France;
authors.forename: Justine
authors.initials: J
authors.lastname: Gellen-Dautremer
authors.affiliation: Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France; Departement de Biochimie-Pharmacotoxicologie.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Loric
authors.affiliation: Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France; Departement de Biochimie-Pharmacotoxicologie.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Moutereau
authors.affiliation: Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France; Department of Nephrology and Renal Transplantation, Unité INSERM U955, Equipe 21, Idiopathic Nephrotic Syndrome Referral Center, Université Paris-Est Créteil, Creteil, France; and.
authors.forename: Dil
authors.initials: D
authors.lastname: Sahali
authors.affiliation: Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France; Department of Hematology and Immunology Biology, and.
authors.forename: Orianne
authors.initials: O
authors.lastname: Wagner-Ballon
authors.affiliation: Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France; Department of Nephrology and Renal Transplantation, Unité INSERM U955, Equipe 21, Idiopathic Nephrotic Syndrome Referral Center, Université Paris-Est Créteil, Creteil, France; and.
authors.forename: Philippe
authors.initials: P
authors.lastname: Remy
authors.affiliation: Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France; Department of Nephrology and Renal Transplantation, Unité INSERM U955, Equipe 21, Idiopathic Nephrotic Syndrome Referral Center, Université Paris-Est Créteil, Creteil, France; and.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lang
authors.affiliation: Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France; Department of Nephrology and Renal Transplantation, Unité INSERM U955, Equipe 21, Idiopathic Nephrotic Syndrome Referral Center, Université Paris-Est Créteil, Creteil, France; and.
authors.forename: Philippe
authors.initials: P
authors.lastname: Grimbert
authors.affiliation: Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France; Public Health Unit EA (Equipe d'Accueil) 7376 CEpiA (Clinical Epidemiology And Ageing Unit, and.
authors.forename: Etienne
authors.initials: E
authors.lastname: Audureau
authors.affiliation: Department of Internal Medicine, Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France;
authors.forename: Bertrand
authors.initials: B
authors.lastname: Godeau
authors.affiliation: Sickle Cell Referral Center, Department of Internal Medicine, Unité Institut National de la Santé Et de la Recherche Médicale (INSERM) U955, Equipe 2 and Laboratory of Excellence Globule Rouge Excellence (GR-Ex), Paris, France Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France;
authors.forename: Frédéric
authors.initials: F
authors.lastname: Galacteros
authors.affiliation: Groupe Hospitalier Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Creteil, France; Department of Nephrology and Renal Transplantation, Unité INSERM U955, Equipe 21, Idiopathic Nephrotic Syndrome Referral Center, Université Paris-Est Créteil, Creteil, France; and pablo.bartolucci@aphp.fr vincent.audard@aphp.fr.
authors.forename: Vincent
authors.initials: V
authors.lastname: Audard
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000188:drug therapy* / Q000209:etiology*; D000755:Anemia, Sickle Cell / Q000150:complications*; D000986:Antisickling Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage*; D008297:Male; D013997:Time Factors
chemical_list: D000986:Antisickling Agents; D006918:Hydroxyurea
keywords: albuminuria; hydroxyurea; sickle cell disease