while another looks on
Credit: NCI
Sickle cell trait may increase the risk of chronic kidney disease (CKD) and poor kidney function, according to a study published in JAMA.
Researchers evaluated nearly 16,000 African Americans and found that subjects with sickle cell trait had a greater risk of CKD and incident CKD than subjects who did not have the trait.
Trait carriers were also more likely to have albuminuria and a decrease in estimated glomerular filtration rate (eGFR), both characteristics of poor kidney function.
This study was released to coincide with its presentation at the American Society of Nephrology’s Kidney Week Annual Meeting.
Rakhi P. Naik, MD, of Johns Hopkins University in Baltimore, and her colleagues conducted this research to investigate the relationship between sickle cell trait and kidney impairment.
The team looked at data from 5 large, population-based studies. They evaluated 15,975 self-identified African Americans—1248 of whom had sickle cell trait and 14,727 who did not.
The researchers assessed the incidence of CKD, which was defined as an eGFR of <60 mL/min/1.73m2 at baseline or follow-up, and incident CKD. They also assessed the rate of albuminuria, which was defined as a spot urine albumin:creatinine ratio of >30mg/g or albumin excretion rate >30mg/24 hours, and decline in eGFR, which was defined as a decrease of >3 mL/min/1.73m2 per year.
CKD and incident CKD were more common among sickle cell trait carriers than noncarriers. CKD was present in 19.2% (239/1247) of carriers and 13.5% (1994/14,722) of noncarriers. And incident CKD was present in 20.7% (140/675) of carriers and 13.7% (1158/8481) of noncarriers.
Sickle cell trait was associated with a faster decline in eGFR, as 22.6% (150/665) of carriers and 19.0% (1569/8249) of noncarriers met the definition of eGFR decline.
And the trait was associated with a higher incidence of albuminuria, as 31.8% (154/485) of carriers had albuminuria, compared to 19.6% (1168/5947) of noncarriers.
So subjects with sickle cell trait had a greater risk of CKD (odds ratio [OR], 1.57), incident CKD (OR, 1.79), decline in eGFR (OR, 1.32), and albuminuria (OR, 1.86).
The researchers said the associations found in this study may offer an additional genetic explanation for the increased risk of CKD observed among African Americans compared with other racial groups.
They added that the study also highlights the need for further research into the renal complications of sickle cell trait. Because screening for the trait is widely performed, accurate characterization of disease associations with sickle cell trait is needed to inform policy and treatment recommendations.
