Renin-angiotensin system blockade promotes a cardio-renal protection in albuminuric homozygous sickle cell patients
Corresponding Author
Jean-Philippe Haymann
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Sorbonne Universites UPMC Univ Paris 06, Paris, France
Institut National de la Sante et de la Recherche Medicale, UMR-S 1155, Paris, France
Correspondence: Jean-Philippe Haymann, Service d'Explorations Fonctionnelles, Hopital Tenon, 4 rue de la Chine, 75020 Paris. France.
E-mail: [email protected]
Search for more papers by this authorNadjib Hammoudi
Service de Cardiologie, Hôpital de la Pitie Salpetrière, Assistance Publique-Hopitaux de Paris, Paris, France
Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
Search for more papers by this authorKatia Stankovic Stojanovic
Centre for Sickle Cell Disease, Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorFrederic Galacteros
Centre for Sickle Cell Disease, Hôpital Mondor, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorAnoosha Habibi
Centre for Sickle Cell Disease, Hôpital Mondor, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorVirginie Avellino
Centre for Sickle Cell Disease, Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorPablo Bartolucci
Centre for Sickle Cell Disease, Hôpital Mondor, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorYahia Benzerara
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorJean-Benoit Arlet
Centre for Sickle Cell Disease, Hôpital Européen Georges Pompidou, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorMorad Djebbar
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorEmmanuel Letavernier
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Sorbonne Universites UPMC Univ Paris 06, Paris, France
Institut National de la Sante et de la Recherche Medicale, UMR-S 1155, Paris, France
Search for more papers by this authorGilles Grateau
Centre for Sickle Cell Disease, Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorNathalie Tabibzadeh
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorAlexei Girshovich
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorMichel Chaignon
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorRobert Girot
Centre for Sickle Cell Disease, Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorPierre Levy
Public Health Department, Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorFrancois Lionnet
Centre for Sickle Cell Disease, Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorCorresponding Author
Jean-Philippe Haymann
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Sorbonne Universites UPMC Univ Paris 06, Paris, France
Institut National de la Sante et de la Recherche Medicale, UMR-S 1155, Paris, France
Correspondence: Jean-Philippe Haymann, Service d'Explorations Fonctionnelles, Hopital Tenon, 4 rue de la Chine, 75020 Paris. France.
E-mail: [email protected]
Search for more papers by this authorNadjib Hammoudi
Service de Cardiologie, Hôpital de la Pitie Salpetrière, Assistance Publique-Hopitaux de Paris, Paris, France
Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
Search for more papers by this authorKatia Stankovic Stojanovic
Centre for Sickle Cell Disease, Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorFrederic Galacteros
Centre for Sickle Cell Disease, Hôpital Mondor, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorAnoosha Habibi
Centre for Sickle Cell Disease, Hôpital Mondor, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorVirginie Avellino
Centre for Sickle Cell Disease, Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorPablo Bartolucci
Centre for Sickle Cell Disease, Hôpital Mondor, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorYahia Benzerara
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorJean-Benoit Arlet
Centre for Sickle Cell Disease, Hôpital Européen Georges Pompidou, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorMorad Djebbar
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorEmmanuel Letavernier
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Sorbonne Universites UPMC Univ Paris 06, Paris, France
Institut National de la Sante et de la Recherche Medicale, UMR-S 1155, Paris, France
Search for more papers by this authorGilles Grateau
Centre for Sickle Cell Disease, Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorNathalie Tabibzadeh
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorAlexei Girshovich
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorMichel Chaignon
Service d'Explorations Fonctionnelles Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorRobert Girot
Centre for Sickle Cell Disease, Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorPierre Levy
Public Health Department, Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorFrancois Lionnet
Centre for Sickle Cell Disease, Hôpital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France
Search for more papers by this authorSummary
The management of sickle cell nephropathy (SCN) at an early stage is an important issue to prevent renal and cardiovascular morbidity and mortality. This study aimed to evaluate in this population, whether angiotensin converting enzyme inhibitors (ACEIs) treatment could exert a cardio-renal protection in a SCN cohort. Forty-two SCN patients (urine albumin:creatinine ratio (ACR) > 10 mg/mmol) were treated with ACEIs for 6 months, then evaluated for ACR, measured glomerular filtration rate (mGFR) together with haematological and cardiovascular parameters. A 1-month washout was also performed in order to differentiate short- and long-term ACEIs effects. A decrease in ACR baseline value (>30%) was detected in 62% of cases (mean ACR: 46·4 ± 7·6 and 26·4 ± 3·9 mg/mmol at baseline and 6 months respectively; P = 0·002), whereas mGFR values were unchanged. ACR decrease was detected at 1 month following ACEI initiation (32·9 ± 6·9, P = 0·02) with a persistent trend after withdrawal (P = 0·08). ACEIs also decreased diastolic blood pressure (P = 0·007), pulse wave velocity (P = 0·01), tricuspid regurgitation velocity (TRV; P = 0·04), asymmetric dimethyl arginine (ADMA: P = 0·001) and haemoglobin (P = 0·01) while conventional haemolytic biomarkers were unchanged. Our data suggest that ACEIs are safe and effective at decreasing albuminuria in sickle cell patients with a beneficial effect on specific mortality risk factors, such as TRV and asymmetric dimethyl arginine.
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