Proteinuria in adults with sickle-cell disease: the role of hydroxycarbamide(hydroxyurea) as a protective agent

• Published in: International journal of clinical pharmacy 2014-08, Vol.36 (4), p.766-770
• Main Authors: Silva Junior, Geraldo B., Vieira, Ana Patrícia F., Couto Bem, Amanda X., Alves, Marília P., Meneses, Gdayllon C., Martins, Alice M. C., Araújo, Sonia M. H. A., Libório, Alexandre V., Daher, Elizabeth F.
• Format: Article
• Language: English
• Subjects: Adult; Anemia, Sickle Cell - blood; Anemia, Sickle Cell - drug therapy; Anemia, Sickle Cell - physiopathology; Anemia, Sickle Cell - urine; Antisickling Agents - therapeutic use; Brazil; Cohort Studies; Female; Glomerular Filtration Barrier - drug effects; Glomerular Filtration Barrier - physiopathology; Glomerular Filtration Rate - drug effects; Hospitals, University; Humans; Hydrogen-Ion Concentration; Hydroxyurea - therapeutic use; Internal Medicine; Kidney - drug effects; Kidney - physiopathology; Kidney Concentrating Ability - drug effects; Kidney diseases; Male; Medicine; Medicine & Public Health; Middle Aged; Outpatient Clinics, Hospital; Pharmacy; Preventive medicine; Proteinuria - etiology; Proteinuria - prevention & control; Research Article; Severity of Illness Index; Sickle cell disease; Young Adult
• ISSN: 2210-7703; 2210-7711
• DOI: 10.1007/s11096-014-9955-4

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. Setting 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. Main outcome measure 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 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). Conclusion SCD is associated with important renal abnormalities. Hydroxycarbamide seems to protect kidney function in SCD by decreasing proteinuria but not microalbuminuria.