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Clinical and genetic predictors of renal dysfunctions in sickle cell anaemia in Cameroon
Author(s) -
Geard Amy,
Pule Gift D.,
Chetcha Chemegni Bernard,
Ngo Bitoungui Valentina J.,
Kengne Andre P.,
Chimusa Emile R.,
Wonkam Ambroise
Publication year - 2017
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.14724
Subject(s) - albuminuria , medicine , renal function , creatinine , mean corpuscular volume , body mass index , endocrinology , urology , hematocrit
Summary 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 APOL 1 and HMOX 1 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 ( HBA 1/ HBA 2 ) deletion, and for variants in APOL 1 (G1/G2; rs60910145, rs73885319, rs71785313) and HMOX 1 (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). APOL 1 G1/G2 risk variants were significantly associated with the ACR ( P = 0·01) and borderline with eGFR ( P = 0·07). HMOX 1 ‐ 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.