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

Authors

1 Department of Paediatrics, College of Medical Science, Gombe State University, Gombe, Nigeria

2 Department of Paediatrics, University of Jos and Jos University Teaching Hospital, Jos, Plateau State, Nigeria

3 Department of Paediatrics, Gombe State University and Federal Teaching Hospital, Gombe State, Nigeria

4 Department of Paediatrics, Bayero University and Aminu Kano Teaching Hospital, Kano State, Nigeria

5 Department of Chemical Pathology, Gombe State University and Federal Teaching Hospital, Gombe State, Nigeria

Abstract

Background: Sickle cell nephropathy is a major cause of morbidity and mortality in sickle cell anaemia (SCA). Proteinuria contributes to progression of renal damage. Microalbuminuria is an early feature of SCN and progression to advanced kidney damage is delayed if regression is achieved with angiotensin converting enzyme inhibitors.
Method: The objective of this single-blind, placebo-controlled randomized controlled trial study was to determine the effect of lisinopril on microalbuminuria in children with SCA. One hundred and seventy 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.
Results: The mean baseline microalbuminuria was 134.2±72.5mg/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/1.73m2 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 were 115.4±26.3 ml/min/1.73m2 and 117.0±33.9ml/min/1.73m2 (p=0.055) in the intervention and placebo groups respectively.
Conclusion: Lisinopril causes reduction of microalbuminuria in children with SCA.
Keywords: Sickle cell nephropathy; microalbuminuria; angiotensin converting enzyme inhibitor; glomerular filtration rate.

Running title: Microalbuminuria and lisinopril in sickle cell anaemia

Keywords