Intravenous Urea Treatment of the Painful Crisis of Sickle-Cell Disease

Abstract

Because it may break the hydrophobic bonds responsible for the sickling phenomenon, urea (40–320 g in 10 per cent invert sugar) was given 24 times to 14 patients for treatment of painful sickle-cell crisis. Seventeen crises were terminated, and the patients became free of pain. The major side effect was massive diuresis. Eight patients responded to 40 g of urea with a plasma urea nitrogen of 40 to 80 mg per 100 ml. Nine required more and attained plasma levels of 60 to 120 mg per 100 ml. The levels were similar in the patients who responded and those who did not.