Sickle Cell Trait and the Risk of ESRD in Blacks
Year: 2017
Type: article
Abstract: Blacks, compared with whites, have an increased risk of progression to end-stage renal disease (ESRD). Emerging evidence suggests that, in addition to APOL1 high-risk genotypes, hemoglobin variants, including sickle cell trait (SCT) and hemoglobin C trait, have a role in kidney disease in blacks. However, the association between these hemoglobin traits and ESRD remains unknown. In a large population-based cohort, the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, we evaluated 9909 self-reported blacks (739 with SCT and 243 with hemoglobin C trait). Incident ESRD occurred in 40 of 739 (5.4%) individuals with SCT, six of 243 (2.5%) individuals with hemoglobin C trait, and 234 of 8927 (2.6%) noncarriers. The incidence rate for ESRD was 8.5 per 1000 person-years for participants with SCT and 4.0 per 1000 person-years for noncarriers. Compared with individuals without SCT, individuals with SCT had a hazard ratio for ESRD of 2.03 (95% confidence interval, 1.44 to 2.84). Hemoglobin C trait did not associate with prevalent CKD or ESRD. The incidence rate for ESRD among participants with APOL1 high-risk genotypes was 6.6 per 1000 person-years, with a hazard ratio for ESRD of 1.77 (95% confidence interval, 1.31 to 2.38) for participants with, compared with those without, APOL1 high-risk genotypes. In this cohort, SCT strongly associated with risk of progression to ESRD in blacks, and this degree of risk for ESRD was similar to that conferred by APOL1 high-risk genotypes. These results may have important public policy implications for genetic counseling of SCT carriers.
Institutions: Johns Hopkins University, Johns Hopkins Medicine, University of Alabama at Birmingham, University of Vermont, Pediatrics and Genetics, University of North Carolina at Chapel Hill, San Francisco VA Medical Center, University of California, San Francisco, University of Kentucky, Emory University, University of Mississippi Medical Center, University of Washington, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, National Cancer Institute, Leidos Biomedical Research Inc. (United States)
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute, National Cancer Institute, National Institute of General Medical Sciences, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke
Awards: VCID and Stroke in a Bi-racial National Cohort, G1671748052, Clinical Hematology Research Career Development Program (K12) at Hopkins, G3157186215, Sickle Cell Trait: An overlooked genetic modifier of disease in African-Americans, APOL1, sickle cell trait and chronic kidney disease in African Americans, G5808129921, G613673199, G6453829601, G6976681869, Regional & Racial Differences in Hemostasis & Risk of Stroke & Heart Disease, G9000008877, G9000191827, Mississippi Center for Clinical and Translational Research
OpenAlex ID: W2592492263