Effect of Lisinopril on Microalbuminuria in Sickle Cell Anaemia Children: A Single-Blind Randomized Controlled Trial

Background Sickle cell nephropathy is a major cause of morbidity and mortality in sickle cell anaemia (SCA). Proteinuria contributes to progression of renal damage. Icroalbuminuria is an early feature of SCN and progression to advanced kidney damage is delayed if regression is achieved with angiotensin converting enzyme inhibitors. We aimed to determine the effect of Lisinopril on microalbuminuria in children with SCA. Materials and Methods In this single-blind, two parallel-arm, placebo-controlled randomized trial study, 170 children aged 1-18 years with SCA and microalbuminuria were randomized into intervention and placebo groups using simple random sampling technique. The intervention and placebo groups received 0.1 mg/kg/day of Lisinopril and 100 mg/day of Vitamin C, respectively and were followed up for 3 months. Microalbuminuria and GFR were determined at baseline, 1, 2, and 3 months. Data were analyzed using SPSS software version 23.0. Results The mean baseline microalbuminuria was 134.2±72.5 mg/g in the intervention group and 107.6±58.0 mg/g in the placebo group (P= 0.009). The mean baseline GFR in the intervention and placebo groups were 122.0±35.6 ml/min/1.73m2 and 121.0±35.6 ml/min/1.73 m2, respectively. There was a significant regression of microalbuminuria in the intervention (84.6%), similar but higher than the placebo group (62.5%) at the end of 3 months’ study. The mean GFR after 3 months on treatments was 115.4±26.3 ml/min/1.73 m2 and 117.0±33.9ml/min/1.73 m2 (p=0.055) in the intervention and placebo groups, respectively.  Conclusion Lisinopril causes significant regression of initial microalbuminuria in children with SCA.

Keywords:

Children , Sickle cell nephropathy , Microalbuminuria , glomerular filtration rate