ESPN 53rd Annual Meeting

ESPN 2021


 
Prevalence and risk factors for the development of kidney damage in sickle cell anemia children
OYINDAMOLA C. ADEBAYO 1 DIEUMERCI K. BETUKUMESU 2 AGATHE B. NKOY 3 OLUYOMI M. ADESOJI 4 PEPE M. EKULU 2 LAMBERTUS P. VAN DEN HEUVEL 3 ELENA LEVTCHENKO 3 VEERLE LABARQUE 1

1- CENTER FOR MOLECULAR AND VASCULAR BIOLOGY, DEPARTMENT OF CARDIOVASCULAR SCIENCES, KATHOLIEKE UNIVERSITEIT LEUVEN, LEUVEN, BELGIUM
2- DIVISION OF NEPHROLOGY, DEPARTMENT OF PEDIATRICS, UNIVERSITY HOSPITAL OF KINSHASA, FACULTY OF MEDICINE, UNIVERSITY OF KINSHASA, DEMOCRATIC REPUBLIC OF CONGO
3- DEPARTMENT OF DEVELOPMENT AND REGENERATION, KATHOLIEKE UNIVERSITEIT LEUVEN, LEUVEN, BELGIUM
4- COLOGNE CENTER FOR GENOMICS, UNIVERSITY OF COLOGNE, COLOGNE, GERMANY
 
Introduction:

 Clinical and genetic factors have been reported to influence the development of sickle cell nephropathy (SCN). However, such data remain limited in the pediatric population. Our study aimed to determine the prevalence of markers of kidney damage and to examine the association between these markers and clinical and genetic factors in children with sickle cell anemia (SCA).

Material and methods:

 In a cross-sectional study, we enrolled 361 patients with sickle cell disease from the Democratic Republic of Congo (DRC). Participants were genotyped for beta-globin gene, Apolipoprotein-L1 (APOL1) G1 and G2 variants, and Heme oxygenase-1 (HMOX1) GT dinucleotide repeats. As main outcomes, albuminuria was defined as urinary albumin-to-creatinine ratio (ACR) ≥ 30mg/g, decreased estimated GFR with creatinine (eGFRcr) when < 60 ml/min/1.73 m2 and hyperfiltration when eGFRcr > 130 and 140 ml/min/1.73 mfor female and male, respectively. 

Results:

From participants enrolled, 326 were confirmed to be SCA patients through genetic sequencing. Albuminuria, hyperfiltration and decreased eGFRcr were presented in 65 (20%), 93 (28%) and 18 (5.50%) patients, respectively. Regression analysis revealed more frequent blood transfusions (P = 0.01), lower diastolic blood pressure (P = 0.04) and male gender (P = 0.02) as clinical determinants of SCN. APOL1 high risk genotype (HRG) (G1/G1, G2/G2, and G1/G2) was significantly associated with albuminuria (odds ratio [OR]: 3.4, 95% confidence interval [CI]: -0.02 – 2.4; P = 0.04) and hyperfiltration (OR: 28.2, 95% CI: 1.3 – 5.4; P = 0.001). HMOX1 GT dinucleotide long repeats were significantly associated with lower eGFRcr (P = 0.03).

Conclusions:

 The study revealed a high burden of kidney damage among children in the DRC. Frequent blood transfusions, male gender and lower diastolic blood pressure were found as the main clinical determinants and evidence has been provided of possible role of APOL1 and HMOX1 in making individuals more susceptible to kidney complications.