Hydroxyurea's Effects on Kidney Function in Sickle Cell Disease

Combination Therapy and Monitoring

• The American Society of Hematology (ASH) suggests combination therapy with hydroxyurea and erythropoiesis-stimulating agents for sickle cell disease patients with chronic kidney disease and worsening anemia 1
• This recommendation is based on evidence that erythropoiesis-stimulating agents may allow for more aggressive hydroxyurea dosing in patients with mild renal insufficiency 2
• For patients with sickle cell disease receiving combination therapy with erythropoiesis-stimulating agents, hemoglobin levels should not exceed 10 g/dL (hematocrit of 30%) to reduce the risk of vaso-occlusive complications 1
• The ASH guideline panel identified the need for more research on the effects of hydroxyurea on kidney function, particularly studies examining its potential to slow progression of end-organ damage 2