Losartan to Reverse Sickle Nephropathy

Exclusion Criteria

• •1. Patients with Hb SC, SD, Sβ+thal, SE and other sickle hemoglobinopathies, and sickle trait (AS).
• •2. Pregnant or lactating females, or females of child-bearing potential that are unable to use a medically accepted form of contraception throughout the study.
• •3. Urine creatinine clearance (Clcr) \<60 mL/minute/1.73 m2
• •4. Gross (not microscopic) hematuria. If hematuria has resolved for 2 weeks or more, patients will be eligible.
• •5. Hyperkalemia (K≥5.5) at baseline despite a low potassium diet
• •6. Concurrent condition that predisposes to nephropathy, such as lupus, diabetes, and hypertension, not controlled with medications..
• •7. On a renin-angiotensin pathway inhibitor (e.g., captopril, lisinopril, Losartan, valsartan, etc) for the last two weeks prior to enrollment.
• •8. Hypersensitivity to Angiotensin II receptor blockers such as losartan, valsartan, telmisartan.
• •9. Patients on red cell apheresis or ongoing aggressive chronic transfusions (one or more a month with a goal of HbS \< 30%). Patients receiving a simple transfusion for symptoms during acute event will be eligible, but if they receive a partial or full exchange transfusion during an acute event, then they will only be eligible after 90 days.
• •10. Hepatic dysfunction defined as ALT (alanine aminotransferase) or direct bilirubin \> 3-times upper limit of normal (ULN).
• •11. Chronic therapy with NSAIDS or Cox2 inhibitors
• •12. On another interventional trial. May be eligible two weeks after completion of another interventional study.
• •13. Any condition that interferes with the ability of the patient to understand or comply with the treatment plan and follow up.
• •14. A serious mental or physical illness or a major disease (cardiac, renal, hepatic, neurological, endocrine, metabolic, pulmonary function or psychiatric), which in the opinion of the investigator would compromise participation in the study.
• •15. Unable to take oral medications.
• •16. HIV confirmed positive.
• •17. Chronic therapy with steroids. May be eligible after three weeks of completing steroid therapy.
• •18. Patients on lithium will be excluded