Title | Association of sickle cell trait with chronic kidney disease and albuminuria in African Americans. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Naik RP, Derebail VK, Grams ME, Franceschini N, Auer PL, Peloso GM, Young BA, Lettre G, Peralta CA, Katz R, Hyacinth HI, Quarells RC, Grove ML, Bick AG, Fontanillas P, Rich SS, Smith JD, Boerwinkle E, Rosamond WD, Ito K, Lanzkron S, Coresh JJ, Correa A, Sarto GE, Key NS, Jacobs DR, Kathiresan S, Bibbins-Domingo K, Kshirsagar AV, Wilson JG |
Secondary Authors | Reiner AP |
Journal | JAMA |
Volume | 312 |
Issue | 20 |
Pagination | 2115-25 |
Date Published | 2014 Nov 26 |
ISSN | 1538-3598 |
Keywords | Adult, African Americans, Aged, Albuminuria, Cohort Studies, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Prospective Studies, Renal Insufficiency, Chronic, Risk, Sickle Cell Trait, United States, Young Adult |
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 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. |
DOI | 10.1001/jama.2014.15063 |
Alternate Journal | JAMA |
PubMed ID | 25393378 |
PubMed Central ID | PMC4356116 |
Grant List | 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 HHSN268201300049C / / PHS 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 U01 HL117659 / HL / NHLBI NIH HHS / United States RC4 MD005964 / MD / NIMHD NIH HHS / United States U01 DK085545 / DK / NIDDK NIH HHS / United States UL1-RR-025005 / RR / NCRR NIH HHS / United States HHSN268201300048C / / PHS HHS / United States AG0005 / AG / NIA NIH HHS / United States HHSN268201300029C / / PHS HHS / United States RC2 HL-102926 / HL / NHLBI NIH HHS / United States HHSN271201100004C / / PHS HHS / United States N01HC95163 / HL / NHLBI NIH HHS / United States HHSN268201100008C / HL / NHLBI NIH HHS / United States HHSN268201100005G / HL / NHLBI NIH HHS / United States HHSN268201100001C / / PHS HHS / United States HHSN268201100004I / HL / NHLBI NIH HHS / United States HHSN268201300025C / / PHS HHS / United States HHSN268201100008I / HL / NHLBI NIH HHS / United States HHSN268201100005C / / PHS 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 HHSN268201300047C / / PHS HHS / United States HHSN268201100009C / / PHS 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 / 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