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Br J Haematol. 2017 Aug;178(4):629-639. doi: 10.1111/bjh.14724. Epub 2017 May 3.

Clinical and genetic predictors of renal dysfunctions in sickle cell anaemia in Cameroon.

Author information

1
Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
2
Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon.
3
Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.

Abstract

Micro-albuminuria and glomerular hyperfiltration are primary indicators of renal dysfunctions in Sickle Cell Disease (SCD), with more severe manifestations previously associated with variants in APOL1 and HMOX1 among African Americans. We have investigated 413 SCD patients from Cameroon. Anthropometric variables, haematological indices, crude albuminuria, albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) were measured. Patients were genotyped for 3·7 kb alpha-globin gene (HBA1/HBA2) deletion, and for variants in APOL1 (G1/G2; rs60910145, rs73885319, rs71785313) and HMOX1 (rs3074372, rs743811). The median age was 15 years; the majority presented with micro-albuminuria (60·9%; n = 248), and approximately half with glomerular hyperfiltration (49·5%; n = 200). Age, male sex, haemoglobin level, leucocyte count, mean corpuscular volume, blood pressure, body mass index and creatinine levels significantly affected albuminuria and/or eGFR. Co-inheritance of alpha-thalassaemia was protective against macro-albuminuria (P = 0·03). APOL1 G1/G2 risk variants were significantly associated with the ACR (P = 0·01) and borderline with eGFR (P = 0·07). HMOX1 - rs743811 was borderline associated with micro-albuminuria (P = 0·07) and macro-albuminuria (P = 0·06). The results revealed a high proportion of micro-albuminuria and glomerular hyperfiltration among Cameroonian SCD patients, and support the possible use of targeted genetic biomarkers for risks assessment.

KEYWORDS:

APOL1 ; HMOX1 ; albuminuria; glomerular filtration rate; sickle cell disease

PMID:
28466968
PMCID:
PMC5660286
DOI:
10.1111/bjh.14724
[Indexed for MEDLINE]
Free PMC Article

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