BLOOD-PRESSURE AND URINARY ALBUMIN EXCRET ION IN ADULT PATIENTS WITH SICKLE-CELL DISEASE

Objective: The increase of urinary albumin excretion could be associat ed with morbidity in patients with sickle cell disease. The objective of this study was to evaluate the relation between blood pressure and urinary albumin excretion, and to estimate the prevalence of hypertens ion according to the level of urinary albumin excretion. Methods: A cr oss-sectional study was carried in 77 patients,vith sickle cell diseas e (48 patients with haemoglobin SS, 29 with haemoglobin SC) et 30 cont rols with haemoglobin AA. The patients with sickle cell disease were d ivided into 3 groups according to urinary albumin excretion: less than 30 mg daily (group I: normoalbuminuria); from 30 to 300 mg daily (gro up II: microalbuminuria); above 300 mg daily (group III: macroalbuminu ria). All AA selected controls had normoalbuminuria (group IV). Result s: In normoalbuminuric patients, the average of blood pressure was sig nificantly lower in patients with sickle cell disease than in controls (respectively 115.0 +/- 8.1 vs 132.1 +/- 15.1, p = 4.10(-6) for systo lic pressure and 67.2 +/- 8.0 vs 78.8 +/- 9.8 mmHg, p = 10(-4) for dia stolic pressure). There was a positive relation between urinary albumi n excretion, even moderate (values less than or equal to 300 mg daily) and blood pressure in SS patients (r = 0.40, p < 0.02 for systolic an d r = 0.54, p < 0.01 for diastolic pressure) and in SC patients (r = 0 .74, p < 0.001 and r = 0.58, p < 0.01). The prevalence of hypertension was 0% in group I, 25% in group II and 66% in group III. Conclusion: The positive association between blood pressure and urinary albumin ex cretion suggests that the latter should be taken into account in sickl e cell disease's follow up.