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This research aims to investigate the effects of renin-angiotensin-aldosterone system inhibitors on anemia in sickle cell disease patients.

June 3, 2026Blood

Renin-Angiotensin-Aldosterone System Inhibition Exacerbates Anemia in Sickle Cell Disease

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This research aims to investigate the effects of renin-angiotensin-aldosterone system inhibitors on anemia in sickle cell disease patients.
Cross-sectional analysis of 658 participants from the Walk-PHaSST study.
Assessment of hemoglobin levels with adjustments for various clinical factors.
Longitudinal cohorts analysis of 56 patients treated with RAAS inhibitors to compare pre- and post-treatment hemoglobin.
Independent association of RAASi use with lower hemoglobin (β -0.46±0.21; P=0.032).
Reduction in hemoglobin levels post-treatment by -0.44±0.14g/dL (P=0.006) and -0.53±0.17g/dL (P=0.005) in two treatment cohorts.
Lower hemoglobin and reticulocyte counts in SCD mice treated with losartan (P<0.001 and P=0.03 respectively).

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Cross-sectional analysis finds RAAS inhibitors reduce hemoglobin in patients with sickle cell disease, indicating potential risks.

Eskandari et al. (2026) studied this question.

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