Association of sickle cell trait with chronic kidney disease and albuminuria in African Americans
- PMID: 25393378
- PMCID: PMC4356116
- DOI: 10.1001/jama.2014.15063
Association of sickle cell trait with chronic kidney disease and albuminuria in African Americans
Abstract
Importance: The association between sickle cell trait (SCT) and chronic kidney disease (CKD) is uncertain.
Objective: To describe the relationship between SCT and CKD and albuminuria in self-identified African Americans.
Design, setting, and participants: Using 5 large, prospective, US population-based studies (the Atherosclerosis Risk in Communities Study [ARIC, 1987-2013; n = 3402], Jackson Heart Study [JHS, 2000-2012; n = 2105], Coronary Artery Risk Development in Young Adults [CARDIA, 1985-2006; n = 848], Multi-Ethnic Study of Atherosclerosis [MESA, 2000-2012; n = 1620], and Women's Health Initiative [WHI, 1993-2012; n = 8000]), we evaluated 15,975 self-identified African Americans (1248 participants with SCT [SCT carriers] and 14,727 participants without SCT [noncarriers]).
Main outcomes and measures: Primary outcomes were CKD (defined as an estimated glomerular filtration rate [eGFR] of <60 mL/min/1.73 m2 at baseline or follow-up), incident CKD, albuminuria (defined as a spot urine albumin:creatinine ratio of >30 mg/g or albumin excretion rate >30 mg/24 hours), and decline in eGFR (defined as a decrease of >3 mL/min/1.73 m2 per year). Effect sizes were calculated separately for each cohort and were subsequently meta-analyzed using a random-effects model.
Results: A total of 2233 individuals (239 of 1247 SCT carriers [19.2%] vs 1994 of 14,722 noncarriers [13.5%]) had CKD, 1298 (140 of 675 SCT carriers [20.7%] vs 1158 of 8481 noncarriers [13.7%]) experienced incident CKD, 1719 (150 of 665 SCT carriers [22.6%] vs 1569 of 8249 noncarriers [19.0%]) experienced decline in eGFR, and 1322 (154 of 485 SCT carriers [31.8%] vs 1168 of 5947 noncarriers [19.6%]) had albuminuria during the study period. Individuals with SCT had an increased risk of CKD (odds ratio [OR], 1.57 [95% CI, 1.34-1.84]; absolute risk difference [ARD], 7.6% [95% CI, 4.7%-10.8%]), incident CKD (OR, 1.79 [95% CI, 1.45-2.20]; ARD, 8.5% [95% CI, 5.1%-12.3%]), and decline in eGFR (OR, 1.32 [95% CI, 1.07-1.61]; ARD, 6.1% [95% CI, 1.4%-13.0%]) compared with noncarriers. Sickle cell trait was also associated with albuminuria (OR, 1.86 [95% CI, 1.49-2.31]; ARD, 12.6% [95% CI, 7.7%-17.7%]).
Conclusions and relevance: Among African Americans in these cohorts, the presence of SCT was associated with an increased risk of CKD, decline in eGFR, and albuminuria, compared with noncarriers. These findings suggest that SCT may be associated with the higher risk of kidney disease in African Americans.
Conflict of interest statement
Figures
Comment in
-
Risk factors: sickle cell trait increases the risk of chronic kidney disease.Nat Rev Nephrol. 2015 Feb;11(2):65. doi: 10.1038/nrneph.2014.229. Epub 2014 Dec 2. Nat Rev Nephrol. 2015. PMID: 25447128 No abstract available.
Similar articles
-
Association of Sickle Cell Trait With Incidence of Coronary Heart Disease Among African American Individuals.JAMA Netw Open. 2021 Jan 4;4(1):e2030435. doi: 10.1001/jamanetworkopen.2020.30435. JAMA Netw Open. 2021. PMID: 33399855 Free PMC article.
-
Cardiovascular Outcomes in African Americans with Sickle Cell Trait and Chronic Kidney Disease.Am J Nephrol. 2019;49(2):93-102. doi: 10.1159/000496058. Epub 2019 Jan 9. Am J Nephrol. 2019. PMID: 30625463
-
Thirty-year risk of ischemic stroke in individuals with sickle cell trait and modification by chronic kidney disease: The atherosclerosis risk in communities (ARIC) study.Am J Hematol. 2019 Dec;94(12):1306-1313. doi: 10.1002/ajh.25615. Epub 2019 Sep 10. Am J Hematol. 2019. PMID: 31429114 Free PMC article.
-
Sickle Cell Trait and Renal Function in Hispanics in the United States: The Northern Manhattan Study.Ethn Dis. 2017 Jan 19;27(1):11-14. doi: 10.18865/ed.27.1.11. Ethn Dis. 2017. PMID: 28115816 Free PMC article.
-
A Meta-analysis of the Association of Estimated GFR, Albuminuria, Age, Race, and Sex With Acute Kidney Injury.Am J Kidney Dis. 2015 Oct;66(4):591-601. doi: 10.1053/j.ajkd.2015.02.337. Epub 2015 May 2. Am J Kidney Dis. 2015. PMID: 25943717 Free PMC article. Review.
Cited by
-
Genetic association and transferability for urinary albumin-creatinine ratio as a marker of kidney disease in four Sub-Saharan African populations and non-continental individuals of African ancestry.Front Genet. 2024 May 15;15:1372042. doi: 10.3389/fgene.2024.1372042. eCollection 2024. Front Genet. 2024. PMID: 38812969 Free PMC article.
-
Evaluation of kidney disease using e-GFR compared to measured creatinine clearance.Bioinformation. 2024 Mar 31;20(3):229-233. doi: 10.6026/973206300200229. eCollection 2024. Bioinformation. 2024. PMID: 38711996 Free PMC article.
-
Novel Therapeutic Approaches in the Management of Chronic Kidney Disease.Biomedicines. 2023 Oct 11;11(10):2746. doi: 10.3390/biomedicines11102746. Biomedicines. 2023. PMID: 37893119 Free PMC article. Review.
-
Sickle Cell Trait and Circulating Proteome.Clin J Am Soc Nephrol. 2023 Nov 1;18(11):1391-1392. doi: 10.2215/CJN.0000000000000320. Epub 2023 Oct 2. Clin J Am Soc Nephrol. 2023. PMID: 37783470 No abstract available.
-
Differences in the Circulating Proteome in Individuals with versus without Sickle Cell Trait.Clin J Am Soc Nephrol. 2023 Nov 1;18(11):1416-1425. doi: 10.2215/CJN.0000000000000257. Epub 2023 Aug 3. Clin J Am Soc Nephrol. 2023. PMID: 37533140
References
-
- Tsaras G, Owusu-Ansah A, Boateng FO, Amoateng-Adjepong Y. Complications associated with sickle cell trait: a brief narrative review. Am J Med. 2009;122(6):507–512. - PubMed
-
- Becton LJ, Kalpatthi RV, Rackoff E, et al. Prevalence and clinical correlates of microalbuminuria in children with sickle cell disease. Pediatr Nephrol. 2010;25(8):1505–1511. - PubMed
-
- Heller P, Best WR, Nelson RB, Becktel J. Clinical implications of sickle cell trait and glucose-6-phosphate dehydrogenase deficiency in hospitalized black male patients. N Engl J Med. 1979;300(18):1001–1005. - PubMed
Publication types
MeSH terms
Grants and funding
- T32 HL007208/HL/NHLBI NIH HHS/United States
- U01 DK085501/DK/NIDDK NIH HHS/United States
- HHSN268201100012C/HL/NHLBI NIH HHS/United States
- K08 HL125100/HL/NHLBI NIH HHS/United States
- RC2 HL102419/HL/NHLBI NIH HHS/United States
- HHSN268201100001I/HL/NHLBI NIH HHS/United States
- HHSN268201100009I/HL/NHLBI NIH HHS/United States
- RC2 HL102923/HL/NHLBI NIH HHS/United States
- N01-HC-95162/HC/NHLBI NIH HHS/United States
- R01 DK102134/DK/NIDDK NIH HHS/United States
- 5K12 HL087097-0/HL/NHLBI NIH HHS/United States
- N01HC95160/HL/NHLBI NIH HHS/United States
- 5RC2HL102419/HL/NHLBI NIH HHS/United States
- U54 HG003067/HG/NHGRI NIH HHS/United States
- R01 HL107816/HL/NHLBI NIH HHS/United States
- 1R01DK102134-01/DK/NIDDK NIH HHS/United States
- U01 DK085524/DK/NIDDK NIH HHS/United States
- RC2 HL102926/HL/NHLBI NIH HHS/United States
- R01HL59367/HL/NHLBI NIH HHS/United States
- HHSN268201100010C/HL/NHLBI NIH HHS/United States
- DK085524/DK/NIDDK NIH HHS/United States
- UL1 RR025005/RR/NCRR NIH HHS/United States
- UL1-RR-025005/RR/NCRR NIH HHS/United States
- AG0005/AG/NIA NIH HHS/United States
- RC2 HL-102926/HL/NHLBI NIH HHS/United States
- U01 DK085545/DK/NIDDK NIH HHS/United States
- U01 HL117659/HL/NHLBI NIH HHS/United States
- RC4 MD005964/MD/NIMHD NIH HHS/United States
- N01HC95163/HL/NHLBI NIH HHS/United States
- HHSN268201100008C/HL/NHLBI NIH HHS/United States
- HHSN268201100005G/HL/NHLBI NIH HHS/United States
- HHSN268201100004I/HL/NHLBI NIH HHS/United States
- HHSN268201100008I/HL/NHLBI NIH HHS/United States
- R01 DK089174/DK/NIDDK NIH HHS/United States
- 5U54HG003067/HG/NHGRI NIH HHS/United States
- R01 HL059367/HL/NHLBI NIH HHS/United States
- R01HL107816/HL/NHLBI NIH HHS/United States
- HHSN268201100007C/HL/NHLBI NIH HHS/United States
- R01HL071862/HL/NHLBI NIH HHS/United States
- N01-HC-95163/HC/NHLBI NIH HHS/United States
- N01-HC-95168/HC/NHLBI NIH HHS/United States
- N01HC95169/HL/NHLBI NIH HHS/United States
- K12 HL087097/HL/NHLBI NIH HHS/United States
- HHSN268201100046C/HL/NHLBI NIH HHS/United States
- RC2 HL-102923/HL/NHLBI NIH HHS/United States
- HHSN268201100011I/HL/NHLBI NIH HHS/United States
- HHSN268201100011C/HL/NHLBI NIH HHS/United States
- R01 HL086694/HL/NHLBI NIH HHS/United States
- 2K12HL087169-06/HL/NHLBI NIH HHS/United States
- N01-HC-95159/HC/NHLBI NIH HHS/United States
- 1UO1HL117659/HL/NHLBI NIH HHS/United States
- HHSN268201300048C/HL/NHLBI NIH HHS/United States
- HHSN268201100003C/WH/WHI NIH HHS/United States
- N01-HC-95165/HC/NHLBI NIH HHS/United States
- N01HC95164/HL/NHLBI NIH HHS/United States
- HHSN268201300025C/HL/NHLBI NIH HHS/United States
- U54 HG003273/HG/NHGRI NIH HHS/United States
- U01 HG004402/HG/NHGRI NIH HHS/United States
- T32 GM007753/GM/NIGMS NIH HHS/United States
- R01 HL080494/HL/NHLBI NIH HHS/United States
- N01HC95162/HL/NHLBI NIH HHS/United States
- N01HC95168/HL/NHLBI NIH HHS/United States
- U01HG004402/HG/NHGRI NIH HHS/United States
- HHSN268201300027C/HL/NHLBI NIH HHS/United States
- RC2 HL-102924/HL/NHLBI NIH HHS/United States
- HHSN268201300049C/HL/NHLBI NIH HHS/United States
- HHSN268201100006C/HL/NHLBI NIH HHS/United States
- RC2 HL102924/HL/NHLBI NIH HHS/United States
- K12 HL087169/HL/NHLBI NIH HHS/United States
- R01HL087641/HL/NHLBI NIH HHS/United States
- HHSN268200900041C/HL/NHLBI NIH HHS/United States
- HHSN268201300028C/HL/NHLBI NIH HHS/United States
- N01-HC-95169/HC/NHLBI NIH HHS/United States
- HHSN268201100005I/HL/NHLBI NIH HHS/United States
- HHSN271201100004C/AG/NIA NIH HHS/United States
- N01-HC-95164/HC/NHLBI NIH HHS/United States
- N01HC95165/HL/NHLBI NIH HHS/United States
- N01HC95159/HL/NHLBI NIH HHS/United States
- UL1-TR-000040/TR/NCATS NIH HHS/United States
- N01HC95161/HL/NHLBI NIH HHS/United States
- U01 DK085526/DK/NIDDK NIH HHS/United States
- R01 HL071862/HL/NHLBI NIH HHS/United States
- HHSN268201300050C/HL/NHLBI NIH HHS/United States
- N01-HC-95160/HC/NHLBI NIH HHS/United States
- U01 DK085584/DK/NIDDK NIH HHS/United States
- HHSN268201100002C/WH/WHI NIH HHS/United States
- HHSN268201300047C/HL/NHLBI NIH HHS/United States
- DK085584/DK/NIDDK NIH HHS/United States
- R01 DK076770/DK/NIDDK NIH HHS/United States
- DK085545/DK/NIDDK NIH HHS/United States
- ImNIH/Intramural NIH HHS/United States
- DK085526/DK/NIDDK NIH HHS/United States
- DK085501/DK/NIDDK NIH HHS/United States
- RC2 HL-102925/HL/NHLBI NIH HHS/United States
- S21 MD000101/MD/NIMHD NIH HHS/United States
- R21 HL123677/HL/NHLBI NIH HHS/United States
- N01HC95167/HL/NHLBI NIH HHS/United States
- RC4MD005964/MD/NIMHD NIH HHS/United States
- HHSN268201100009C/HL/NHLBI NIH HHS/United States
- HHSN268201100005C/HL/NHLBI NIH HHS/United States
- T32HL007208/HL/NHLBI NIH HHS/United States
- RC2 HL103010/HL/NHLBI NIH HHS/United States
- HHSN268201100007I/HL/NHLBI NIH HHS/United States
- N01-HC-95161/HC/NHLBI NIH HHS/United States
- UL1 TR000040/TR/NCATS NIH HHS/United States
- HHSN268201300046C/HL/NHLBI NIH HHS/United States
- HHSN268201100003I/HL/NHLBI NIH HHS/United States
- HHSN268201100002I/HL/NHLBI NIH HHS/United States
- HL080494-05/HL/NHLBI NIH HHS/United States
- N01HC95166/HL/NHLBI NIH HHS/United States
- HHSN268201300029C/HL/NHLBI NIH HHS/United States
- N01-HC-95166/HC/NHLBI NIH HHS/United States
- R01 HL087641/HL/NHLBI NIH HHS/United States
- R01 DK076770-01/DK/NIDDK NIH HHS/United States
- HHSN268201100001C/WH/WHI NIH HHS/United States
- RC2 HL-103010/HL/NHLBI NIH HHS/United States
- RC2 HL102925/HL/NHLBI NIH HHS/United States
- HHSN268201100004C/WH/WHI NIH HHS/United States
- N01-HC-95167/HC/NHLBI NIH HHS/United States
- R01HL086694/HL/NHLBI NIH HHS/United States
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials
Miscellaneous