Hydroxyurea treatment decreases glomerular hyperfiltration in children with sickle cell anemia
Version of Record online: 17 DEC 2012
Copyright © 2012 Wiley Periodicals, Inc.
American Journal of Hematology
Volume 88, Issue 2, pages 116–119, February 2013
How to Cite
Aygun, B., Mortier, N. A., Smeltzer, M. P., Shulkin, B. L., Hankins, J. S. and Ware, R. E. (2013), Hydroxyurea treatment decreases glomerular hyperfiltration in children with sickle cell anemia. Am. J. Hematol., 88: 116–119. doi: 10.1002/ajh.23365
- Issue online: 24 JAN 2013
- Version of Record online: 17 DEC 2012
- Accepted manuscript online: 17 NOV 2012 03:05AM EST
- Manuscript Accepted: 7 NOV 2012
- Manuscript Revised: 1 NOV 2012
- Manuscript Received: 12 JUL 2012
- National Heart, Lung and Blood Institute. Grant Number: R01HL090941 (REW) and ALSAC
Glomerular hyperfiltration and microalbuminuria/proteinuria are early manifestations of sickle nephropathy. The effects of hydroxyurea therapy on these renal manifestations of sickle cell anemia (SCA) are not well defined. Our objective was to investigate the effects of hydroxyurea on glomerular filtration rate (GFR) measured by 99mTc-DTPA clearance, and on microalbuminuria/proteinuria in children with SCA. Hydroxyurea study of long-term effects (HUSTLE) is a prospective study (NCT00305175) with the goal of describing the long-term cellular, molecular, and clinical effects of hydroxyurea therapy in SCA. Glomerular filtration rate, urine microalbumin, and serum cystatin C were measured before initiating hydroxyurea therapy and then repeated after 3 years. Baseline and Year 3 values for HUSTLE subjects were compared using the Wilcoxon Signed Rank test. Associations between continuous variables were evaluated using Spearman correlation coefficient. Twenty-three children with SCA (median age 7.5 years, range, 2.5–14.0 years) received hydroxyurea at maximum tolerated dose (MTD, 24.4 ± 4.5 mg/kg/day, range, 15.3–30.6 mg/kg/day). After 3 years of treatment, GFR measured by 99mTc-DTPA decreased significantly from 167 ± 46 mL/min/1.73 m2 to 145 ± 27 mL/min/1.73 m2 (P = 0.016). This decrease in GFR was significantly associated with increase in fetal hemoglobin (P = 0.042) and decrease in lactate dehydrogenase levels (P = 0.035). Urine microalbumin and cystatin C levels did not change significantly. Hydroxyurea at MTD is associated with a decrease in hyperfiltration in young children with SCA. Am. J. Hematol., 88:116–119, 2013. © 2012 Wiley Periodicals, Inc.