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December 8, 2025Blood

Renin-angiotensin-aldosterone system inhibitors exacerbate anemia in sickle cell disease

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Authors

EPEmma PappanoNENajmeh EskandariMFMarwah Farooqui

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Overview

Cross-sectional and longitudinal studies show RAAS inhibitors decrease hemoglobin in sickle cell disease, indicating caution in their use.

Key Points

  • To assess the effects of renin-angiotensin-aldosterone system inhibitors on anemia in sickle cell disease.
  • Analyzed cross-sectional and longitudinal data from sickle cell disease cohorts
  • Compared hemoglobin, reticulocyte percent, and Epo concentrations
  • Utilized transgenic sickle cell mice for treatment response analysis
  • RAAS inhibitors associated with lower hemoglobin concentrations in patients
  • Longitudinal data showed accelerated decline in hemoglobin on RAAS treatment
  • Transgenic mice treated with losartan had significantly lower hemoglobin after 6 and 14 weeks

Cite This Study

Pappano et al. (2025) studied this question.

synapsesocial.com/papers/69362f484fa91c937236d702https://doi.org/10.1182/blood-2025-297
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Renin-angiotensin-aldosterone system inhibition exacerbates anemia in sickle cell disease2026 · 1 citations
  2. 2Kidney Function Decline in Sickle Cell Disease2026
  3. 3Targeting hemolysis and raas: Osivelotor and losartan ameliorate sickle cell renal pathology2025
  4. 4Reduced blood pressure in sickle cell disease is associated with decreased angiotensin converting enzyme (ACE) activity and is not modulated by ACE inhibition2022 · 12 citations
  5. 5Erythropoietin is reduced by combination of diuretic therapy and RAAS blockade in proteinuric renal patients with preserved renal function2010 · 13 citations